Innovative Framework to Assess the Costs of Untreated Agitation in Alzheimer’s Disease (AAD)

Abstract

AbstractBackgroundIn the past decade, researchers and advocates have taken steps towards quantifying the full costs of Alzheimer’s disease and related dementias. However, our current understanding of these costs does not fully consider the behavioral symptoms of dementia, notably agitation. Agitation in Alzheimer’s disease contributes to negative social and financial outcomes for people with the condition, their care partners, and health systems. When left untreated, the negative impact of these outcomes is exacerbated, yet the scale of this impact is unknown. A review of the literature shows that there are no frameworks to help assess the true costs of agitation calling for a need for further research and assessment.MethodWe created a Markov model that investigates each stage of Alzheimer’s disease with agitation. The model utilizes five transition states with six‐month cycles. This framework assesses direct and indirect costs of disease. Direct costs include professional caregiving, non‐pharmacological intervention, nursing home costs, healthcare professional consultations, and hospitalizations. Indirect costs of disease evaluated include loss of income and value of unpaid caregiving. To establish the difference in cost to understand true costs of untreated disease, this model will allow us to compare outcomes associated with intervention with that of no intervention, from which one can derive an Incremental Cost‐Effectiveness Ratio (ICER). Additionally, we used quality‐adjusted life years to measure disease burden and health outcomes. Finally, we utilized a deterministic and probabilistic sensitivity analysis to assess the robustness of this model.ResultResults will describe a finalized Markov model with which one can assess the costs of untreated agitation in Alzheimer’s. This discussion will include perspectives and feedback from key opinion leaders in Alzheimer’s research, care, and economics from across the worldConclusionAgitation has severe consequences on individuals, families, and health systems. Oftentimes one of the first symptoms of Alzheimer’s or dementia, agitation can increase the caregiving responsibilities, trigger placement into nursing homes, and cause severe emotional and physical toll on care partners. We cannot understand the full costs of dementia or AD until we account for untreated agitation vis‐à‐vis a multi‐symptom assessment. This framework is the first step in evaluating the costs of agitation.