Health, social and economic consequences of dementias: a comparative national cohort study

TY - JOUR

T1 - Health, social and economic consequences of dementias

T2 - a comparative national cohort study

AU - Frahm-Falkenberg, S.

AU - Ibsen, Rikke

AU - Kjellberg, J.

AU - Jennum, P.

PY - 2016

Y1 - 2016

N2 - Background and purpose: Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register based cohort study. Methods: Using records from the Danish National Patient Registry (1997–2009) all patients with a diagnosis of Alzheimer's disease, vascular dementia or dementia not otherwise specified and their partners were identified and compared with randomly chosen controls matched for age, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period – before and after diagnosis. Results: In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social- and health-related vulnerability was identified years prior to diagnosis. The average annual additional cost of direct healthcare costs and lost productivity in the years before diagnosis was 2082 euros per patient over and above that of matched controls, and 4544 euros per patient after the time of diagnosis. Conclusions: Dementias cause significant morbidity and mortality, consequently generating significant socioeconomic costs.

AB - Background and purpose: Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register based cohort study. Methods: Using records from the Danish National Patient Registry (1997–2009) all patients with a diagnosis of Alzheimer's disease, vascular dementia or dementia not otherwise specified and their partners were identified and compared with randomly chosen controls matched for age, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period – before and after diagnosis. Results: In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social- and health-related vulnerability was identified years prior to diagnosis. The average annual additional cost of direct healthcare costs and lost productivity in the years before diagnosis was 2082 euros per patient over and above that of matched controls, and 4544 euros per patient after the time of diagnosis. Conclusions: Dementias cause significant morbidity and mortality, consequently generating significant socioeconomic costs.

KW - Alzheimer

KW - dementia

KW - employment

KW - health costs

KW - mortality

KW - national patient registry

KW - partner

KW - socioeconomic costs

U2 - 10.1111/ene.13043

DO - 10.1111/ene.13043

M3 - Journal article

C2 - 27297659

AN - SCOPUS:84982182547

SN - 1351-5101

VL - 23

SP - 1400

EP - 1407

JO - European Journal of Neurology

JF - European Journal of Neurology

IS - 9

ER -