A review of cost of illness in Alzheimer’s research

Linh Chi Hoang, Hien Nguyen Thi, Thai Ha Tran


This study provides an vidence of the cost drivers of Alzheimer’s disease (AD) across care settings and associated factors. In total, 14 studies from different systematic reviews of cost-of-illness (COI) studies in AD were published from 1998 to 2017. PubMed (Medline), Embase, PsycInfo, and Cochrane Library were selected to search. The total annual cost for AD is up to US$73,986.9 per patient. The highest nursing home cost for each level of AD was US$25632.9, US$30,469.2, and US$74,457.8. In the included studies, the informal cost was the main cost driver due to nursing home care/social care and loss of leisure time rather than direct medical costs (inpatient and outpatient care). The results of this review underline the significant economic burden of AD for patients, families, and healthcare systems, and thus, recommending further health policy planning in AD should clearly define cost components and separate estimates by care setting and disease severity.


Health economic; economic evaluation; Alzheimer disease; cost of illness; review

Full Text:



Salloway S, Correia S. Alzheimer disease: time to improve its diagnosis and treatment. Cleve Clin J Med. 2009;76(1):49-58.

Sevilla C, Jimenez Caballero PE, Alfonso V, Gonzalez-Adalid M. Current treatments of Alzheimer disease: are main caregivers satisfied with the drug treatments received by their patients? Dement Geriatr Cogn Disord. 2009;28(3):196-205.

Jia J, Wei C, Chen S, et al. The cost of Alzheimer's disease in China and re-estimation of costs worldwide. 2018;14(4):483-491.

Dodel R, Belger M, Reed C, et al. Determinants of societal costs in Alzheimer's disease: GERAS study baseline results. 2015;11(8):933-945.

Aajami Z, Kebriaeezadeh A, Nikfar S. Direct and indirect cost of managing Alzheimer’s disease in the Islamic Republic of Iran. 2019;18(1):7-12.

Gustavsson A, Brinck P, Bergvall N, et al. Predictors of costs of care in Alzheimer's disease: a multinational sample of 1222 patients. Alzheimers Dement. 2011;7(3):318-327.

Olazarán J, Agüera-Ortiz L, Argimón JM, et al. Costs and quality of life in community-dwelling patients with Alzheimer's disease in Spain: Results from the GERAS II observational study. 2017;29(12):2081-2093.

Byford S, Torgerson DJ, Raftery J. Economic note: cost of illness studies. BMJ (Clinical research ed). 2000;320(7245):1335.

Leicht H, Heinrich S, Heider D, et al. Net costs of dementia by disease stage. 2011;124(5):384-395.

Jo C. Cost-of-illness studies: concepts, scopes, and methods. Clin Mol Hepatol. 2014;20(4):327-337.

Darba J, Kaskens L, Lacey L. Relationship between global severity of patients with Alzheimer's disease and costs of care in Spain; Results from the co-dependence study in Spain. 2015;16(8):895-905.

Bloom BS, de Pouvourville N, Straus WL. Cost of illness of Alzheimer's disease: How useful are current estimates? 2003;43(2):158-164.

Doran C. Critique of an Economic Evaluation Using the Drummond Checklist. Applied health economics and health policy. 2010;8:357-359.

Jonsson L, Eriksdotter Jonhagen M, Kilander L, et al. Determinants of costs of care for patients with Alzheimer's disease. 2006;21(5):449-459.

Mesterton J, Wimo A, By A, Langworth S, Winblad B, Jonsson L. Cross sectional observational study on the societal costs of Alzheimer's disease. 2010;7(4):358-367.

Wimo A, Reed CC, Dodel R, et al. The GERAS Study: a prospective observational study of costs and resource use in community dwellers with Alzheimer's disease in three European countries--study design and baseline findings. J Alzheimers Dis. 2013;36(2):385-399.

Lopez-Bastida J, Serrano-Aguilar P, Perestelo-Perez L, Oliva-Moreno J. Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain. 2006;67(12):2186-2191.

Zhu CW, Scarmeas N, Torgan R, et al. Longitudinal study of effects of patient characteristics on direct costs in Alzheimer disease. Neurology. 2006;67(6):998-1005.

Joyce AT, Zhao Y, Bowman L, Flynn JA, Carter CT, Ollendorf DA. Burden of illness among commercially insured patients with Alzheimer's disease. 2007;3(3):204-210.

Kraft E, Marti M, Werner S, Sommer H. Cost of dementia in Switzerland. 2010;140:w13093