Treating Alzheimer’s in Older Adults Lowers All-Cause Health Care Costs, Study Suggests

August 4, 2016

Read 2017 AAIC conference coverage here

Findings from a study presented at AAIC 2016 suggest that dementia treatment, specifically in older adults with severe comorbidities, can result in lower all-cause health care costs and lower mortality rates compared to untreated patients.

Because there is currently no treatment that changes the underlying course of Alzheimer’s disease (AD), few studies have examined existing medical therapies for their economic and mortality impact, including comparing treated versus untreated people with newly diagnosed AD in the United States.

Patients with ≥ 1 primary or ≥ 2 secondary AD diagnoses claims were identified from Medicare fee-for-service claims. Patients were assigned to treated and non-treated cohorts based on anti-dementia treatment received post-index date. Mortality incidence rate (100 person-years), health care costs, and utilizations were evaluated post-index date.

A total of 6,553 incident AD patients were identified, mostly female (74.22%) between 75-84 years (39.72%). Patients received anti-dementia medication (N=2,322; 35%) on average 34 days post-AD diagnosis. Treated patients received donepezil (66.86%), memantine (18.59%), rivastigmine (12.54%), and galantamine (2.02%) as their first treatment. Untreated patients were older (83.85 vs 81.44 years, P < 0.0001), with more severe baseline comorbidities and high unadjusted incidence rate of death (17.36 vs 10.00; in 100 person-years, P < 0.0001).

Treated AD patients had better survival (HR= 0.722, P = 0.0079), less monthly hospice visits (0.04 vs 0.09, P = 0.0001), and lower monthly all-cause cost ($2,207 vs $2,349, P = 0.3037) compared to untreated patients.

“The arguments for early treatment are myriad, but this study shows greater survival and less all-cause health care costs among those receiving treatment for dementia,” said presenting author Christopher M Black, MPH, Merck Research Laboratories (Kenilworth, NJ). “These results indicate that choosing not to treat, or even a delay in starting treatment, may lead to less favorable results.” —Amanda Del Signore