The Excess Costs of Dementia: A Systematic Review and Meta-Analysis

TY - JOUR

T1 - The Excess Costs of Dementia: A Systematic Review and Meta-Analysis

AU - Sontheimer, Nadine

AU - Konnopka, Alexander

AU - König, Hans-Helmut

PY - 2021/8/31

Y1 - 2021/8/31

N2 - Background: Dementia is one of the costliest diseases for health care systems with growing importance for policy makers. Objective: The aim of this study is to systematically review the current literature of excess cost studies for dementia and to analyze excess costs in a meta-analysis. Methods: A systematic literature search was conducted in PubMed, EconLit, NHS-EED, and Cochrane Library. 22 studies were included and assigned to one of three subgroups according to the time period that they analyzed during disease progression: the time of diagnosis, the time between diagnosis and death, and the time prior to death. Excess costs were analyzed using the ratio of means (ROM) and meta-analysis was performed by pooling ROMs in a random effects model. Results: Total costs were significantly higher for demented persons compared to non-demented persons at the time of diagnosis (ROM: 2.08 [1.71, 2.54], p  < 0.00001, I 2  = 98%) and in the time period between diagnosis and death (ROM: 2.19 [1.97, 2.44], p  < 0.00001, I 2  = 100%). The ROM was highest for professional home care (ROM: 4.96 [2.62, 9.40], p  < 0.0001, I 2  = 88%) and for nursing facilities (ROM: 4.02 [2.53, 6.40], p  < 0.00001, I 2  = 100%) for the time period between diagnosis and death. Conclusion: This meta-analysis is the first to assess excess costs of dementia by the ROM method on a global scale. We conclude that our findings demonstrate that costs of dementia constitute a substantial economic burden.

AB - Background: Dementia is one of the costliest diseases for health care systems with growing importance for policy makers. Objective: The aim of this study is to systematically review the current literature of excess cost studies for dementia and to analyze excess costs in a meta-analysis. Methods: A systematic literature search was conducted in PubMed, EconLit, NHS-EED, and Cochrane Library. 22 studies were included and assigned to one of three subgroups according to the time period that they analyzed during disease progression: the time of diagnosis, the time between diagnosis and death, and the time prior to death. Excess costs were analyzed using the ratio of means (ROM) and meta-analysis was performed by pooling ROMs in a random effects model. Results: Total costs were significantly higher for demented persons compared to non-demented persons at the time of diagnosis (ROM: 2.08 [1.71, 2.54], p  < 0.00001, I 2  = 98%) and in the time period between diagnosis and death (ROM: 2.19 [1.97, 2.44], p  < 0.00001, I 2  = 100%). The ROM was highest for professional home care (ROM: 4.96 [2.62, 9.40], p  < 0.0001, I 2  = 88%) and for nursing facilities (ROM: 4.02 [2.53, 6.40], p  < 0.00001, I 2  = 100%) for the time period between diagnosis and death. Conclusion: This meta-analysis is the first to assess excess costs of dementia by the ROM method on a global scale. We conclude that our findings demonstrate that costs of dementia constitute a substantial economic burden.

KW - Alzheimer’s disease

KW - cost of illness

KW - costs and cost analysis

KW - dementia

KW - economics

U2 - 10.3233/JAD-210174

DO - 10.3233/JAD-210174

M3 - SCORING: Zeitschriftenaufsatz

VL - 83

SP - 333

EP - 354

JO - J ALZHEIMERS DIS

JF - J ALZHEIMERS DIS

SN - 1387-2877

IS - 1

ER -