COSTS OF ALZHEIMER’S DISEASE AND DEMENTIA IN 188 COUNTRIES

There were approximately forty five million people living with Alzheimer's disease and other dementias around the world in 2017. Treatment for patients with dementia is costly and it is often not covered by insurance or formal healthcare systems. The cost of dementia already poses a major economic burden on the care systems in developed countries and it is increasing in developing countries. Comparable estimates of spending on Alzheimer's and other dementias are necessary to help allocate scarce healthcare resources and efficiently treat this vulnerable population. We conducted a systematic review on the treatment cost of Alzheimer's disease and other dementias. We searched PubMed and Google Scholar for disease expenditure and cost of illness studies published between 2000 and 2016. 275 studies were identified for extraction after appraisal for methodological quality. Total and per-capita direct and indirect cost were extracted as well as data on informal care. Cost data from the World Mental Health Surveys was also included in our model. Country level prevalence, GDP, and wage data were obtained from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD). Spatiotemporal Gaaussian process regression was used to generate complete and comparable estimates for Alzheimer's and other dementias spending in 188 countries. All estimates are adjusted for the effects of inflation and are reported in the 2018 purchasing power parity-adjusted dollars. The global cost of Alzheimer's disease and other dementias will exceed one trillion PPP dollars in 2018. Close to eighty per cent of the costs occurred in high-income countries, with less than 50% of the prevalence. The majority of the costs are informal, reflecting the heavy economic burden of indirect and social care. Care for Alzheimer's disease and other dementias pose an enormous economic burden for healthcare systems around the world. Cost will continue to increase due to aging populations and emerging treatments. Comprehensive, comparable cost estimates are an excellent tool for policy makers worldwide. They are helpful to learn from the spending practices of other countries as well as to better allocate the resources of in their own health systems.