Ari Rosenvall, Lauri Sääksvuori, Harriet Finne-Soveri, Ismo Linnosmaa, Antti Malmivaara
Mehiläinen Ympyrätalo, Helsinki, Finland. E-mail: antti.malmivaara@thl.fi
DOI: 10.2340/16501977-2722

Objective: To compare the costs and monetary benefits of non-pharmacological interventions for patients with Alzheimer’s disease in real-world settings.
Methods: A systematic review was performed to determine the most effective treatment strategies for being able to stay at home for patients with Alzheimer’s disease. Care-management, family support, and multidisciplinary rehabilitation were identified as effective interventions applicable in the Finnish healthcare setting. Data on medical and social service costs, and the costs of residential care for all patients newly diagnosed with Alzheimer’s disease in 2 major cities in Finland were analysed in a 4-year follow-up study. The potential cost savings of the different treatment strategies were assessed.
Results: The annual cost increased from €9,481 to €28,400 (mean per patient) during the 4-year follow-up. Cost savings were achieved in care-management, family support programmes, and rehabil­itative cognitive and social activation if the patients’ transition to long-term care was delayed by 2. 8, 1. 8 and 43. 0 days, respectively.
Conclusion: Care-management and informal caregiver support for patients with Alzheimer’s disease may benefit patients and result in concurrent cost savings. Delaying the decline in cognitive and social functioning through rehabilitation is indicated for more severe phases of Alzheimer’s disease, and the costs appear to be compensated by savings in the cost of long-term care.

Alzheimer’s disease is the most common reason for institutionalized long-term care in Europe and the USA. The aim of this study was to compare the costs and monetary benefits of non-pharmacological interventions for Alzheimer’s disease in real-world settings, by analysing comprehensive 4-year follow-up data for all new patients with Alzheimer’s disease in the 2 largest cities in Finland. In this systematic review care-management, family support, and multidisciplinary rehabilitation were identified as effective interventions for patients with Alzheimer’s disease. These interventions were found to be cost saving if patients’ transition to long-term care was delayed by 2.8, 1.8 and 43.0 days, respectively. Care-management and informal caregiver support for patients with Alzheimer’s disease appear to benefit patients and result in cost savings for society. Multidisciplinary rehabilitation is indicated for more severe phases of Alzheimer’s disease, and the costs appear to be compensated by monetary savings in long-term care.

Figure S1
Figure S2
Table SI
Table SII
Table SIII