title: Epidemiological and economic burden of Alzheimer's disease: a systematic literature review of data across Europe and the United States of America.
abstract: BACKGROUND
  Alzheimer's disease (AD) weighs heavily on health expenditure and is strongly associated with increasing age. Due to population aging, increasing global prevalence of AD will pose huge challenges to public health and elderly care systems in all countries across the world.
  
  
  OBJECTIVE
  This study aimed to better understand the burden of AD from a healthcare perspective.
  
  
  METHODS
  A systematic literature review of journal articles published between January 2002 and December 2012 was performed for studies conducted in France, Germany, Italy, The Netherlands, Spain, the United Kingdom (UK), and the United States of America (USA), using Medline, Embase, and the NHS Economic Evaluation Database.
  
  
  RESULTS
  3,288 references were initially retrieved, and 39 epidemiological and 66 economic publications were selected for data extraction. AD incidence rates greatly varied between countries; however, prevalence was more consistent across all included countries, ranging between 3-7%. Overall, medical costs were lower in France compared to other included countries and increased with AD severity, e.g., direct medical costs per year for mild AD ranged from 5,476 int$ in France to 27,380 int$ in Spain. Limitations, such as heterogeneous methodology and missing data, prevented the comparison of results across studies between countries or the conclusion of any trend over time.
  
  
  CONCLUSIONS
  This review corroborates previous understanding that AD burden is high for both society and healthcare providers. Limitations regarding study heterogeneity restricted conclusions; further research is required. Stakeholders could benefit from new healthcare strategies addressing both epidemiological and economic aspects of AD.
authors.affiliation: Nestlé Health Science, Vevey, Switzerland.
authors.forename: Claire
authors.initials: C
authors.lastname: Takizawa
authors.affiliation: Mapi, London, UK.
authors.forename: Paula L
authors.initials: PL
authors.lastname: Thompson
authors.affiliation: Mapi, Houten, The Netherlands.
authors.forename: Anneloes
authors.initials: A
authors.lastname: van Walsem
authors.affiliation: Mapi, Lyon, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Faure
authors.affiliation: Mapi, London, UK.
authors.forename: William C
authors.initials: WC
authors.lastname: Maier
mesh_terms: D000544:Alzheimer Disease / Q000191:economics* / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D014481:United States / Q000453:epidemiology
keywords: Alzheimer's disease; direct costs; economic; epidemiology; incidence; indirect costs; medical costs; mortality; non-medical costs; prevalence