Health, social and economic consequences of dementias: a comparative national cohort study.
Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register based cohort study.



Using records from the Danish National Patient Registry (1997-2009) all patients with a diagnosis of Alzheimer's disease, vascular dementia or dementia not otherwise specified and their partners were identified and compared with randomly chosen controls matched for age, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period - before and after diagnosis.



In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social- and health-related vulnerability was identified years prior to diagnosis. The average annual additional cost of direct healthcare costs and lost productivity in the years before diagnosis was 2082 euros per patient over and above that of matched controls, and 4544 euros per patient after the time of diagnosis.



Dementias cause significant morbidity and mortality, consequently generating significant socioeconomic costs.
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Glostrup, Denmark.
S
S
Frahm-Falkenberg
I2minds, Aarhus, Denmark.
R
R
Ibsen
Danish Institute for Health Services Research, Copenhagen, Denmark.
J
J
Kjellberg
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Glostrup, Denmark.
P
P
Jennum
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D017281:Cost of Illness; D003704:Dementia / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D015140:Dementia, Vascular / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D003718:Denmark / Q000453:epidemiology; D004651:Employment; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012737:Sex Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D055815:Young Adult
Alzheimer; dementia; employment; health costs; mortality; national patient registry; partner; socioeconomic costs