Dementia care costs and outcomes: a systematic review

Martin Knapp, Valentina Iemmi, Renee Romeo

Research output: Contribution to journalArticlepeer-review

99 Citations (Scopus)

Abstract

Objective
We reviewed evidence on the cost-effectiveness of prevention, care and treatment strategies in relation to dementia.

Methods
We performed a systematic review of available literature on economic evaluations of dementia care, searching key databases and websites in medicine, social care and economics. Literature reviews were privileged, and other study designs were included only to fill gaps in the evidence base. Narrative analysis was used to synthesise the results.

Results
We identified 56 literature reviews and 29 single studies offering economic evidence on dementia care. There is more cost-effectiveness evidence on pharmacological therapies than other interventions. Acetylcholinesterase inhibitors for mild-to-moderate disease and memantine for moderate-to-severe disease were found to be cost-effective. Regarding non-pharmacological treatments, cognitive stimulation therapy, tailored activity programme and occupational therapy were found to be more cost-effective than usual care. There was some evidence to suggest that respite care in day settings and psychosocial interventions for carers could be cost-effective. Coordinated care management and personal budgets held by carers have also demonstrated cost-effectiveness in some studies.

Conclusion
Five barriers to achieving better value for money in dementia care were identified: the scarcity and low methodological quality of available studies, the difficulty of generalising from available evidence, the narrowness of cost measures, a reluctance to implement evidence and the poor coordination of health and social care provision and financing
Original languageEnglish
Pages (from-to)551-61
Number of pages11
JournalInternational Journal of Geriatric Psychiatry
Volume28
Issue number6
Early online date12 Aug 2012
DOIs
Publication statusPublished - Jun 2013

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