2023 American Academy of Neurology Abstract Website

Objective:

To conduct a systematic literature review (SLR) assessing the economic impact of Alzheimer’s disease (AD), with an emphasis on care partners and disease progression.

Background:

AD significantly impacts care partners.

Design/Methods:

A protocol was developed before searches in PubMed, Embase, and PsycINFO were run in November 2021 via the Silvi.ai-platform. SLR conduct followed standard guidelines. Eligible studies were in English and provided data from January 2011–November 2021.

Results:

Of 1043 hits, 25 studies were relevant for data extraction. AD costs were defined heterogeneously between studies; however, most studies included AD and non-AD drugs and out- and in-patient visits. Seven studies specifically explored the cost burden of AD for care partners: hours needed to support the partner, loss of work productivity, and implications for future employability. Monthly caretaking cost was similar across studies and countries, varying between €6435–€10503 for mild AD in Germany and Spain, €8045–€13295 for moderate AD in France and Germany, and €15154–€23765 for severe AD in the UK and Germany. The major cost driver was clinical status severity of the patient. Few studies reported care partner work impairment. One study comparing matched care versus non-care partners demonstrated significantly higher activity impairment (25.4% vs. 21.8%) and greater absenteeism (5.4% vs. 3.1%), presenteeism-related impairment (22.7% vs. 18.4%), and overall work impairment (25.8% vs. 20.4%). An increase in work impairment with AD severity was seen across countries (US, Japan, and EU5).

Conclusions:

Most studies focused on the cost burden on society or patients. In seven studies reporting cost impact on care partners, cost burden was similar across countries and health care systems. Cost impact on care partners increased from early to severe AD, particularly for work impairment. More research is needed to identify the true cost burden for care partners.