Custo e Carga da Doença de Alzheimer nos Idosos em Portugal

Abstract

Introduction: Alzheimer’s disease is a progressive, multifactorial neurodegenera-tive brain disorder. Alzheimer’s disease is the main cause of dementia with substan-tial humanistic and economic burden. This study estimated the disease burden and societal costs associated with Alzheimer’s disease in patients aged ≥ 65 years, in mainland Portugal, in 2018. Methods: The burden of disease and cost of illness were estimated using a prev-alence-based approach. Burden of disease was measured in disability-adjusted life years (DALY), estimated as the sum of years of life lost (YLL) due to premature mortality with years lived with disability (YLD). Costs were estimated using a societal perspective and included medical and non-medical direct costs. Results: We estimated 143 334 elderly patients with Alzheimer’s disease in 2018 (7% of the population ≥65 years). In 2018, there were 7538 deaths attributed to Alz-heimer’s disease that resulted in the loss of 76 709 YLL. A total of 45 754 YLD were attributed to Alzheimer’s disease. The overall burden was 122 463 DALY. The estimated direct medical costs attributable to Alzheimer’s disease in 2018 were €219 million (including €166 million for outpatient care, €29 million for inpatient care and €24 million for medication). Non-medical direct costs totalled 1.8 billion (including €1.1 billion attributed to informal care, €551 million for social care, €122 million for sup-port devices, accessories of care and home physical adaptations, and €40 million for transport costs). The total estimated cost amounted to €2 billion in 2018. Conclusion: Alzheimer’s disease has a major socioeconomic impact, being respon-sible for 7% of the total YLL estimated for mainland Portugal. Costs related to informal care represent more than half (54%) of the total costs attributed to Alzheimer´s disease, the latter being equivalent to 1% of the Portuguese gross domestic product.