Abstract
Alzheimer’s disease is one of several diseases of the elderly that has recently come into prominence for a number of reasons. First, its prevalence is set to increase as a result of the aging of Western populations. Secondly, the use of institutional care has fallen as a result of major policy changes in many countries, and this has caused a shift in the pattern of care for the elderly. Finally, the advent of innovative pharmacotherapy has caused third-party payers and clinicians to question the way in which this disease is best managed.
International epidemiological data for Western populations point to a potentially considerable increase in the prevalence of the disease over the next 2 decades. Although the cost estimates of the disease vary widely among, or indeed, within different Western countries, they may be considerable. It is clear that innovative strategies, e.g. the use of respite care, sheltered housing and pharmacotherapy, might serve to limit the amount of time patients spend in institutional care. Even a small reduction in this form of care might be sufficient to offset the costs of treatment.
What is lacking today are clear demonstrations as to how these new strategies might contribute to the overall management of this complex and multifactorial disease: this should be the joint focus of care providers and the pharmaceutical industry in the near future.
Similar content being viewed by others
References
Aronson MK, Ooi WL, Geva DL, et al. Age-dependent incidence, prevalence, and mortality in the old. Arch Intern Med 1991; 151: 989–92
Bosanquet N, May J, Johnson N. Alzheimer’s disease in the UK: burden of disease and future care. Health Policy Review No. 12. London: Imperial College of Science and Technology, 1998
Bickel H, Cooper B. Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Psychol Med 1994; 24: 179–92
Rocca WL, Hofman A, Brayne C, et al. Frequency and distribution of Alzheimer’s disease in Europe: a collaborative study of 1980–1990 prevalence findings. Ann Neurol 1991; 30: 381–90
Alzheimer’s Disease Society. The Alzheimer’s disease report, caring for dementia today and tomorrow. London: Alzheimer’s Disease Society, 1993
Cavello MC, Fattore G. The economic and social burden of Alzheimer’s disease on families in the Lombardy region of Italy. Alzheimer Dis Assoc Disord 1997; 11 (4): 184–90
Ernst RL, Hay JW. Economic research on Alzheimer disease: a review of the literature. Alzheimer Dis Assoc Dis 1997; 11 (6): 135–45
Alzheimer’s Association. Facts and statistics/prevalence [online]. Available from: URL: http://www.alz.org/facts/rtstats.htm [Accessed 1999 Aug 03]
Canadian Study of Health and Aging Working Group. Canadian Study of Health and Aging: study methods and prevalence of dementia. Can Med Assoc J 1994; 150 (6): 899–913
US Census Bureau. International Data Base (IDB) [online]. Available from: URL: http://www.census.gov/ipc/www/idbnew.html [Accessed 1999 Aug 05]
Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand 1987; 76: 465–79
Katzman R, Kawas C. The epidemiology of dementia and Alzheimer’s disease. In: Terry RD, Katzman R, Bick KI, editors. Alzheimer’s disease. New York (NY): Raven Press, 1994: 105–22
Ritchie K, Kildea D. Is senile dementia ‘age-related’ or ageing-related? - evidence from meta-analysis of dementia prevalence in the oldest old. Lancet 1995; 346: 931–4
Gray A, Fenn P. Alzheimer’s disease: the burden of the illness in England. Health Trends 1993; 25: 31–7
Schneider J, Kavanagh S, Knapp M, et al. Elderly people with advanced cognitive impairment in England: resource use and costs. Aging Soc 1993; 13: 27–59
Ernst RL, Hay J. The US economic and social costs of Alzheimer’s disease revisited. Am J Public Health 1994; 84: 1261–4
Østbye T, Crosse E. Net economic costs of dementia in Canada. Can Med Assoc J 1994; 151 (10): 1457–64
Meek PD, McKeithan EK, Schumock GT. Economic considerations in Alzheimer’s disease. Pharmacotherapy 1998; 18 (2): 68s-73s
Souêtre E, Thawaites RMA, Yeardly HL. Economic impact of Alzheimer’s disease in the UK: cost of care and disease severity for non-institutionalised patients with Alzheimer’s disease. Br J Psychiatry 1999; 174: 51–5
Greener M. Counting the cost of Alzheimer’s disease. Pharmaceutical Times 1999 May: 19
Hux MJ, O’Brien B, Iskedjian M, et al. Relation between severity of Alzheimer’s disease and costs of caring. Can Med Assoc J 1998; 159: 457–65
Bosanquet N, Huttin C, Kurz A, et al. Alzheimer’s disease: an international perspective on care delivery. Health Policy Review Paper No. 11. London: Imperial College of Science, Technology and Medicine, University of London, 1997
Portrait of seniors in Canada. Ottawa: Statistics Canada, 1990
Care of elderly: market survey. London: Laing and Buisson, 1995
Pear R. Clinton seeks aid for the care of those with chronic ills. New York Times 1999 Jan 4: A1
Kavanagh S, Schneider J, Knapp M, et al. Elderly people with dementia: costs, effectiveness and balance of care. In: Knapp M, editor. The economic evaluation of mental health care. Aldershot: Arena, 1995: 125–56
Foster RH, Plosker GL. Donepezil: pharmacoeconomic implications of therapy. Pharmacoeconomics 1999; 16 (1): 99–114
O’Brien BJ, Goeree R, Hux M, et al. Economic evaluation of donepezil for the treatment of Alzheimer’s disease in Canada. J Am Geriatr Soc 1999; 47 (5): 570–8
Kanowski S. Cost benefit evaluation of drug treatment for Alzheimer’s disease. Arch Gerontol Geriatr 1998; Suppl. 6: 275–80
Flicker L. Acetylcholinesterase inhibitors for Alzheimer’s disease. BMJ 1999; 318: 615–6
Donoghue J, Slee A. Can the NHS afford new Alzheimer’s disease treatments? Pharmacists as patient advocates. Pharm J 1998; 260: 84
Alzheimer’s Research Forum [online]. Available from: URL: http://www.alzforum.org/members/research/drugs/index.html [Accessed 1999 Aug 02]
Leon J, Cheng CK, Neumann P. Alzheimer’s disease care: costs and potential savings. Health Affairs 1998; 17 (6): 206–16
Three new Alzheimer’s programs, including respite care begin. Disease Management News 1998 Aug 10; 3–4
Garner P, Godel M. Specialised early care for Alzheimer’s (SPECAL): making a present of the past. Oxford: Oxfordshire Mental Healthcare NHS Trust, 1996
The Paignton and Brixham GP project. Torquay: South Devon Carers Consortium, 1996 Apr [start date]
The Swedish Institute. The health care system in Sweden. Swedish Institute’s fact sheets on Sweden series. Stockholm: The Swedish Institute, 1994 [also available online at http://www.si.se/eng/epubl/epubl.html]
Acknowledgements
While the authors have conducted sponsored research in the past, the views contained in the current paper are those of the authors for which none of them has received sponsorship.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Johnson, N., Davis, T. & Bosanquet, N. The Epidemic of Alzheimer’s Disease. Pharmacoeconomics 18, 215–223 (2000). https://doi.org/10.2165/00019053-200018030-00002
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-200018030-00002