Informal care hours and societal costs in patients with dementia

Abstract

Few economic analyses have evaluated resource utilisation in dementia (RUD) and assessed informal care hours that contribute to societal costs in patients with dementia in OECD* countries, and the methodology used varies between studies. These were findings of a systematic review published in Health Economics Review. Medline, Embase, PsycINFO and web of science were searched on 1 December 2020 for observational studies, costeffectiveness studies and cost of illness (COI) analyses on RUD in OECD countries published within the previous 20 years which included patients with dementia 65 years of age and over and their caregivers. Of the 26 cross-sectional studies and three longitudinal cohort studies which met the inclusion criteria, only two were randomised controlled trials (RCTs). Methodology and cost categories varied widely between studies. Variables associated with high informal care hours and societal costs included the severity of dementia, caregiver factors, and behavioural and psychological symptoms of dementia (BPSD). One RCT found that a non-pharmacological intervention including 24-hour assistance with activities of daily living and instrumental activities of daily living care had no effect on informal care hours. The other RCT found that an inhome respite care programme was cost effective in reducing informal care hours and costs. The divergent use of the RUD components within RUD studies shows that future economic evaluations and observational studies should be better harmonized, said the authors. Larger sample sizes and longer follow-up periods are required in future RCTs with dedicated focus on cost-enhancing and resource intensive factors such as disease severity and BPSD, they commented.