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Meta-Analysis
. 2023 Jan;41(1):59-75.
doi: 10.1007/s40273-022-01212-z. Epub 2022 Nov 15.

The Costs of Dementia in Europe: An Updated Review and Meta-analysis

Linus Jönsson  1 , Ashley Tate  2 , Oskar Frisell  3 , Anders Wimo  2
Affiliations
Meta-Analysis

The Costs of Dementia in Europe: An Updated Review and Meta-analysis

Linus Jönsson et al. Pharmacoeconomics. 2023 Jan.

Abstract

Background and objective: The prevalence of dementia is increasing, while new opportunities for diagnosing, treating and possibly preventing Alzheimer's disease and other dementia disorders are placing focus on the need for accurate estimates of costs in dementia. Considerable methodological heterogeneity creates challenges for synthesising the existing literature. This study aimed to estimate the costs for persons with dementia in Europe, disaggregated into cost components and informative patient subgroups.

Methods: We conducted an updated literature review searching PubMed, Embase and Web of Science for studies published from 2008 to July 2021 reporting empirically based cost estimates for persons with dementia in European countries. We excluded highly selective or otherwise biased reports, and used a random-effects meta-analysis to produce estimates of mean costs of care across five European regions.

Results: Based on 113 studies from 17 European countries, the estimated mean costs for all patients by region were highest in the British Isles (73,712 EUR), followed by the Nordics (43,767 EUR), Southern (35,866 EUR), Western (38,249 EUR), and Eastern Europe and Baltics (7938 EUR). Costs increased with disease severity, and the distribution of costs over informal and formal care followed a North-South gradient with Southern Europe being most reliant on informal care.

Conclusions: To our knowledge, this study represents the most extensive meta-analysis of the cost for persons with dementia in Europe to date. Though there is considerable heterogeneity across studies, much of this is explained by identifiable factors. Further standardisation of methodology for capturing resource utilisation data may further improve comparability of future studies. The cost estimates presented here may be of value for cost-of-illness studies and economic evaluations of novel diagnostic technologies and therapies for Alzheimer's disease.

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Conflict of interest statement

Linus Jönsson was previously employed by H. Lundbeck, but this work was unrelated to the employment. He is a minority shareholder in H. Lundbeck and has received license fees for the data collection instrument (Resource Utilization in Dementia). Anders Wimo declares that none of the potential list of conflicts of interest listed has had any impact on the conduct of this study. Oskar Frisell and Ashley Tate have no conflicts of interest that are directly relevant to the content of this study.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow chart
Fig. 2
Fig. 2
Distributions of dementia cost over components, by region
Fig. 3
Fig. 3
Mean annual costs per person with dementia, by disease severity, and region
See this image and copyright information in PMC

References

    1. World Health Organization . Global status report on the public health response to dementia. Geneva: World Health Organization; 2021.
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    1. Jönsson L, Wimo A. The cost of dementia in Europe: a review of the evidence, and methodological considerations. Pharmacoeconomics. 2009;27(5):391–403. doi: 10.2165/00019053-200927050-00004. - DOI - PubMed
    1. Quentin W, et al. Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Acta Psychiatr Scand. 2010;121(4):243–259. doi: 10.1111/j.1600-0447.2009.01461.x. - DOI - PubMed

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