Utilization and Lifetime Costs of Formal Care for Alzheimer’s Disease Dementia in Sweden

INTRODUCTION: The study aimed to estimate the utilization and lifetime costs of formal care for individuals with Alzheimer's disease (AD) dementia in Sweden. METHODS: We used longitudinal data from 20,366 individuals (mean age: 78.54 years) diagnosed with AD dementia from the Swedish Register of Cognitive/Dementia Disorders linked to other registers to derive data on formal care utilization, including inpatient and outpatient specialist care, prescribed drugs, and social care. We estimated formal care utilization across AD dementia stages defined by the Mini-Mental State Examination and the lifetime formal care costs (in 2023 Swedish krona, SEK) in patients with AD dementia using the Zhao and Tian estimator, which uses the inverse probability weighting technique to account for censoring due to loss to follow-up. The estimates of lifetime costs were compared with those of controls matched to patients with AD dementia by birth year, sex, and region of residence at the time of diagnosis. RESULTS: The number of outpatient specialist visits decreased as AD severity increased, while the number of drug prescriptions and social care utilization increased with advancing AD stages. The estimated lifetime costs of formal care for AD dementia were 2,440,000 SEK (€212,174; $US230,189; 95% CI 2,088,000-2,793,000 SEK), compared with 510,000 SEK (€44,348; $US48,113; 95% CI 482,000-539,000 SEK) for matched controls. CONCLUSIONS: This study estimated the utilization and lifetime costs of formal care for AD dementia using longitudinal register data. These findings will provide inputs for future economic evaluations of treatments and preventive interventions for AD dementia.