Abstract
INTRODUCTION: Six million Americans live with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD), a major health-care cost driver. We evaluated the cost effectiveness of non-pharmacologic interventions that reduce nursing home admissions for people living with AD/ADRD. METHODS: We used a person-level microsimulation to model the hazard ratios (HR) on nursing home admission for four evidence-based interventions compared to usual care: Maximizing Independence at Home (MIND), NYU Caregiver (NYU); Alzheimer's and Dementia Care (ADC); and Adult Day Service Plus (ADS Plus). We evaluated societal costs, quality-adjusted life years and incremental cost-effectiveness ratios. RESULTS: All four interventions cost less and are more effective (i.e., cost savings) than usual care from a societal perspective. Results did not materially change in 1-way, 2-way, structural, and probabilistic sensitivity analyses. CONCLUSION: Dementia-care interventions that reduce nursing home admissions save societal costs compared to usual care. Policies should incentivize providers and health systems to implement non-pharmacologic interventions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 3867-3893 |
| Number of pages | 27 |
| Journal | Alzheimer's and Dementia |
| Volume | 19 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2023 |
| Externally published | Yes |
Keywords
- caregiving
- cost effectiveness
- dementia
- non-drug interventions
ASJC Scopus subject areas
- Clinical Neurology
- Geriatrics and Gerontology
- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Health Policy
- Developmental Neuroscience
- Epidemiology
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