Potential Savings in Caregiver Time and Societal Costs Associated with Slowing Disease Progression over 36 months in Patients with Early Alzheimer’s Disease: Findings from GERAS‐US

Abstract

AbstractBackgroundAlzheimer’s disease (AD) is associated with significant costs that increase with disease progression. These analyses describe the relationship between cognitive decline and measures of caregiver time and societal costs and estimate the impact of slowing disease progression over 36 months.MethodsAmyloid positive patients with mild cognitive impairment (MCI) and mild AD dementia (MILD) from the GERAS‐US study1 were included. Assessments included: Mini Mental State Examination (MMSE‐ cognition); Resource Utilization in Dementia (RUD‐ caregiver time, societal costs). The generalized linear model (GLM) with normal distribution was performed for caregiver time and with log link and gamma distribution for total societal cost. The associated outcome savings over 36 months were calculated based on least squares mean change (LSMC) in MMSE and coefficient of MMSE change from baseline to month 36.ResultsTable 1 shows baseline characteristics of 617 patients (300 MCI, 317 MILD, 47.3% male) with a mean (SD) age of 71.0 (7.8) years. MILD vs. MCI patients had greater cognitive impairment, higher caregiver time, and higher monthly societal cost. Over 36 months, MILD patients had significantly greater disease progression compared to MCI (MMSE LSMC 4.1 vs. 2.1). A 2.1‐point worsening in MMSE over 36 months for MCI was associated with an increase of 35.7 hours in total caregiver time and an increase of $8,084 per patient in total societal costs (Table 3). Delaying progression by 20% ‐30% could lead to a savings 7.2 to 10.7 hours for caregiver time and $1,675 to $2,502 in total societal costs. For MILD, a 4.1‐point worsening in MMSE was associated with an increase of 77.3 hours in total caregiver time and $12,807 per patient in total societal costs. Delaying progression by 20%‐30% could save 15.5 to 23.2 hours in caregiver time and $2,665 to $ 3,978 in total societal cost.ConclusionCaregiver time and total societal costs are higher in MILD than in MCI; caregiver time increases over 3 years for both MCI and Mild. Treatments that slow cognitive decline have the potential to keep patients in earlier disease stages longer with a resulting savings in caregiver time and societal cost. 1J Alzheimers Dis. 2019;72(1):279‐292