The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors
Abstract Background With the availability of first disease-modifying treatments, evidence on costs across the entire Alzheimer's Continuum, especially for early disease stages, becomes increasingly important to inform healthcare planning, resource allocation, and policy decisions. This study as...
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2025-06-01
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| Series: | Alzheimer’s Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13195-025-01785-9 |
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| author | Eva Gläser Ingo Kilimann Moritz Platen Wolfgang Hoffmann Frederic Brosseron Katharina Buerger Marie Coenjaerts Emrah Düzel Michael Ewers Klaus Fliessbach Ingo Frommann Maria Gemenetzi Wenzel Glanz Julian Hellmann-Regen Enise I. Incesoy Daniel Janowitz Frank Jessen Oliver Peters Josef Priller Alfredo Ramirez Anja Schneider Annika Spottke Eike Jakob Spruth Stefan Teipel Michael Wagner Bernhard Michalowsky |
| author_facet | Eva Gläser Ingo Kilimann Moritz Platen Wolfgang Hoffmann Frederic Brosseron Katharina Buerger Marie Coenjaerts Emrah Düzel Michael Ewers Klaus Fliessbach Ingo Frommann Maria Gemenetzi Wenzel Glanz Julian Hellmann-Regen Enise I. Incesoy Daniel Janowitz Frank Jessen Oliver Peters Josef Priller Alfredo Ramirez Anja Schneider Annika Spottke Eike Jakob Spruth Stefan Teipel Michael Wagner Bernhard Michalowsky |
| author_sort | Eva Gläser |
| collection | DOAJ |
| description | Abstract Background With the availability of first disease-modifying treatments, evidence on costs across the entire Alzheimer's Continuum, especially for early disease stages, becomes increasingly important to inform healthcare planning, resource allocation, and policy decisions. This study assessed costs and cost-associated factors in patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI) and Alzheimer's Disease (AD) dementia compared to healthy controls. Methods The German DELCODE cohort study assessed clinical data, healthcare resource use, and informal care provision. Costs were calculated from payer and societal perspectives using standardized unit costs, and multivariate regression analyses identified cost-associated factors. Results From a payer perspective, costs were elevated by 26% for SCD (adjusted mean 5,976€ [95%CI 4,598-7,355€]), 85% for MCI (8,795€ [6,200-11,391€]) and 36% for AD (6,454€ [2,796-10,111€]) compared to controls (4,754€ [3,586-5,922€]). Societal costs were elevated by 52% for SCD (adjusted mean 8,377€ [95%CI 6,009-10,746€]), 170% for MCI (14,886€ [9,524-20,248€]) and 307% for AD (22,481€ [9,994-34,969€]) compared to controls (5,522€ [3,814-7,230€]). APOE e4 negative patients showed higher costs compared to APOE e4 positive patients. Hypertension was associated with higher costs. Conclusions Healthcare costs are already elevated in early subjective and objective cognitive impairment, driven by formal and informal care. The study emphasizes the importance of early interventions to reduce the economic burden and delay progression. |
| format | Article |
| id | doaj-art-2a82b836bf894c84912e6abd6c4c25ed |
| institution | OA Journals |
| issn | 1758-9193 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | Alzheimer’s Research & Therapy |
| spelling | doaj-art-2a82b836bf894c84912e6abd6c4c25ed2025-08-20T02:37:58ZengBMCAlzheimer’s Research & Therapy1758-91932025-06-0117111310.1186/s13195-025-01785-9The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factorsEva Gläser0Ingo Kilimann1Moritz Platen2Wolfgang Hoffmann3Frederic Brosseron4Katharina Buerger5Marie Coenjaerts6Emrah Düzel7Michael Ewers8Klaus Fliessbach9Ingo Frommann10Maria Gemenetzi11Wenzel Glanz12Julian Hellmann-Regen13Enise I. Incesoy14Daniel Janowitz15Frank Jessen16Oliver Peters17Josef Priller18Alfredo Ramirez19Anja Schneider20Annika Spottke21Eike Jakob Spruth22Stefan Teipel23Michael Wagner24Bernhard Michalowsky25German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Site GreifswaldGerman Center for Neurodegenerative Diseases (DZNE) Rostock/GreifswaldGerman Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Site GreifswaldGerman Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Site GreifswaldGerman Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE, Munich)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE, Munich)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)Institute for Stroke and Dementia Research (ISD), University Hospital, LMU MunichGerman Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE) Rostock/GreifswaldGerman Center for Neurodegenerative Diseases (DZNE)German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Site GreifswaldAbstract Background With the availability of first disease-modifying treatments, evidence on costs across the entire Alzheimer's Continuum, especially for early disease stages, becomes increasingly important to inform healthcare planning, resource allocation, and policy decisions. This study assessed costs and cost-associated factors in patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI) and Alzheimer's Disease (AD) dementia compared to healthy controls. Methods The German DELCODE cohort study assessed clinical data, healthcare resource use, and informal care provision. Costs were calculated from payer and societal perspectives using standardized unit costs, and multivariate regression analyses identified cost-associated factors. Results From a payer perspective, costs were elevated by 26% for SCD (adjusted mean 5,976€ [95%CI 4,598-7,355€]), 85% for MCI (8,795€ [6,200-11,391€]) and 36% for AD (6,454€ [2,796-10,111€]) compared to controls (4,754€ [3,586-5,922€]). Societal costs were elevated by 52% for SCD (adjusted mean 8,377€ [95%CI 6,009-10,746€]), 170% for MCI (14,886€ [9,524-20,248€]) and 307% for AD (22,481€ [9,994-34,969€]) compared to controls (5,522€ [3,814-7,230€]). APOE e4 negative patients showed higher costs compared to APOE e4 positive patients. Hypertension was associated with higher costs. Conclusions Healthcare costs are already elevated in early subjective and objective cognitive impairment, driven by formal and informal care. The study emphasizes the importance of early interventions to reduce the economic burden and delay progression.https://doi.org/10.1186/s13195-025-01785-9DementiaCognitionSubjective cognitive declineMild cognitive impairmentAlzheimer’s diseaseApolipoprotein E |
| spellingShingle | Eva Gläser Ingo Kilimann Moritz Platen Wolfgang Hoffmann Frederic Brosseron Katharina Buerger Marie Coenjaerts Emrah Düzel Michael Ewers Klaus Fliessbach Ingo Frommann Maria Gemenetzi Wenzel Glanz Julian Hellmann-Regen Enise I. Incesoy Daniel Janowitz Frank Jessen Oliver Peters Josef Priller Alfredo Ramirez Anja Schneider Annika Spottke Eike Jakob Spruth Stefan Teipel Michael Wagner Bernhard Michalowsky The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors Alzheimer’s Research & Therapy Dementia Cognition Subjective cognitive decline Mild cognitive impairment Alzheimer’s disease Apolipoprotein E |
| title | The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors |
| title_full | The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors |
| title_fullStr | The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors |
| title_full_unstemmed | The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors |
| title_short | The economic burden of subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia: excess costs and associated clinical and risk factors |
| title_sort | economic burden of subjective cognitive decline mild cognitive impairment and alzheimer s dementia excess costs and associated clinical and risk factors |
| topic | Dementia Cognition Subjective cognitive decline Mild cognitive impairment Alzheimer’s disease Apolipoprotein E |
| url | https://doi.org/10.1186/s13195-025-01785-9 |
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