Cavaco Maria A, Jang Se Ryeong, Olsen Christopher, Bodnar Carolyn, Ferko Nicole
EVERSANA, Burlington, ON, Canada.
Eisai Inc, Nutley, NJ, US.
Neurol Ther. 2025 Aug 27. doi: 10.1007/s40120-025-00815-w.
Alzheimer's disease (AD) is among the costliest of illnesses for the elderly, placing a significant burden on healthcare systems and caregivers. Despite the depth of evidence, reviews lack a holistic assessment of such costs, falling short of illustrating unmet medical needs. The objective of this review was to therefore characterize the total societal economic burden of AD, broken down by care setting and disease severity.
A targeted literature search of systematic reviews, cost-of-illness, and observational studies published between 2013 and 2024 was conducted on MEDLINE and Embase to identify articles reporting the economic burden of AD. Grey literature was hand-searched. Both direct and indirect costs were assessed, including societal burdens not often reported by AD-specific cost-of-illness studies such as financial delinquencies.
In total, 81 articles were reviewed in depth, including 20 systematic reviews and 61 studies or reports. Findings consistently demonstrated that societal costs of AD or dementia typically increased by at least 50% between consecutive severity levels, increasing with disease progression. Informal caregiving often comprised close to half of societal costs, regardless of care setting, disease severity, or region. While studies reporting costs of mild cognitive impairment (MCI) were limited, the economic burden reported for this stage was appreciable compared to mild AD. Evidence for the impact of AD, as early as MCI, on quality of life (e.g., emotional and mental strain) and personal financial management capabilities was also identified.
This review provides a comprehensive overview, from studies spanning over more than a decade, of the substantial societal economic burden associated with AD, across cost categories, care settings, disease stages, and regions. This review may be used to inform health economic evaluations of novel interventions with potential to reduce the enormous and growing global economic burden of AD and dementia.
阿尔茨海默病（AD）是老年人花费最高的疾病之一，给医疗保健系统和护理人员带来了沉重负担。尽管有大量证据，但综述缺乏对这些成本的全面评估，未能说明未满足的医疗需求。因此，本综述的目的是描述AD的社会经济总负担，并按护理环境和疾病严重程度进行细分。
在MEDLINE和Embase上对2013年至2024年发表的系统评价、疾病成本研究和观察性研究进行了有针对性的文献检索，以识别报告AD经济负担的文章。对手头文献进行了人工检索。评估了直接和间接成本，包括AD特定疾病成本研究中不常报告的社会负担，如财务拖欠。
总共深入审查了81篇文章，包括20篇系统评价和61项研究或报告。研究结果一致表明，AD或痴呆症的社会成本通常在连续的严重程度级别之间至少增加50%，并随着疾病进展而增加。无论护理环境、疾病严重程度或地区如何，非正式护理通常占社会成本的近一半。虽然报告轻度认知障碍（MCI）成本的研究有限，但与轻度AD相比，该阶段报告的经济负担相当可观。还发现了AD早在MCI阶段对生活质量（如情绪和精神压力）和个人财务管理能力的影响证据。
本综述对十多年来的研究进行了全面概述，涵盖了与AD相关的巨大社会经济负担，包括成本类别、护理环境、疾病阶段和地区。本综述可用于为新型干预措施的卫生经济评估提供信息，这些干预措施有可能减轻AD和痴呆症日益增长的巨大全球经济负担。
