Missing Uniform Costs Classification for Alzheimer’s Disease Treatment and Care

Background: The importance of the issue of the economic burden of treatment and care for people with dementia is crucial in the developed countries. The European Union and other developed countries are trying to improve the course of aging population which leads to rising costs. Their uniform registration is also one of the objectives of the developed countries’ strategic plans to fight dementia. The individual steps of the plans in practical terms so far are mainly directed to the early diagnosis of diseases, records of the associated data are so far in the background. Aim: The aim of this paper is to specify a set of costs that should be constantly monitored at the national level within dementia. Methods: The main method is a literature review focused on Alzheimer's disease. The searched keywords were "Alzheimer's disease" and "costs" incurred after 2010. The studies will specify the monitored costs and determine their minimal penetration, which will then form the basis for recommendations for the monitored group of costs on a national level. Results: Results of the analysis indicate that the following main cost groups are monitored: medical direct costs (inpatient care, outpatient treatment, medication), non-medical direct costs (day care centres, community health services, respite care, accommodation costs for patients) and indirect costs (time that the carers dedicate to the patient). The issue of different naming and groups of costs calls for a common strategy in this area and defining the minimum items that should be monitored.

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Alzheimer’s disease: a molecular mechanism, new hypotheses, and therapeutic strategies

Medicina ◽

10.3390/medicina46010011 ◽

2010 ◽

Vol 46 (1) ◽

pp. 70 ◽

Cited By ~ 5

Author(s):

Milda Plečkaitytė

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Protein Misfolding ◽

Developed Countries ◽

Therapeutic Strategies ◽

Self Assembling ◽

Parkinson’S Diseases ◽

Cellular Pathogenesis ◽

The Developed Countries ◽

Amyloid Cascade

Human diseases involving protein misfolding and aggregation have received increasing attention in recent years. Alzheimer’s disease and other diseases associated with aging are sweeping the developed countries whose populations are rapidly aging. Recent progress has improved our knowledge about molecular and cellular pathogenesis of these diseases. For more than 20 years, multiple diseases such as Alzheimer’s and Parkinson’s diseases have been associated with accumulation of abnormal protein fibrils. These self-assembling fibrils, referred as “amyloid,” have been considered the pathogenic molecules that cause cellular degeneration. Accumulation of fibrillar Aβ in plaques underlies the theory for Alzheimer’s disease. Recent experiments have provided evidence that fibrils are not the only neurotoxins. Soluble oligomers and protofibrils play a crucial role in causing cellular dysfunction and death. These oligomers, the missing links in the original amyloid cascade hypothesis, have been incorporated into an updated amyloid cascade. Despite new information gained, there is no disease-modifying treatment. New insights into disease mechanisms and new therapeutic strategies give hope for change.

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Current Research Therapeutic Strategies for Alzheimer’s Disease Treatment

Neural Plasticity ◽

10.1155/2016/8501693 ◽

2016 ◽

Vol 2016 ◽

pp. 1-15 ◽

Cited By ~ 107

Author(s):

Jaume Folch ◽

Dmitry Petrov ◽

Miren Ettcheto ◽

Sonia Abad ◽

Elena Sánchez-López ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Metabotropic Glutamate Receptor ◽

Developed Countries ◽

Metabotropic Glutamate ◽

Amyloid A ◽

Slowing Down ◽

Fyn Kinase ◽

Nmdar Activation ◽

The Developed Countries

Alzheimer’s disease (AD) currently presents one of the biggest healthcare issues in the developed countries. There is no effective treatment capable of slowing down disease progression. In recent years the main focus of research on novel pharmacotherapies was based on the amyloidogenic hypothesis of AD, which posits that the beta amyloid (Aβ) peptide is chiefly responsible for cognitive impairment and neuronal death. The goal of such treatments is (a) to reduce Aβproduction through the inhibition ofβandγsecretase enzymes and (b) to promote dissolution of existing cerebral Aβplaques. However, this approach has proven to be only modestly effective. Recent studies suggest an alternative strategy centred on the inhibition of the downstream Aβsignalling, particularly at the synapse. Aβoligomers may cause aberrant N-methyl-D-aspartate receptor (NMDAR) activation postsynaptically by forming complexes with the cell-surface prion protein (PrPC). PrPC is enriched at the neuronal postsynaptic density, where it interacts with Fyn tyrosine kinase. Fyn activation occurs when Aβis bound to PrPC-Fyn complex. Fyn causes tyrosine phosphorylation of the NR2B subunit of metabotropic glutamate receptor 5 (mGluR5). Fyn kinase blockers masitinib and saracatinib have proven to be efficacious in treating AD symptoms in experimental mouse models of the disease.

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Pakistan

Dementia Care: International Perspectives ◽

10.1093/med/9780198796046.003.0010 ◽

2019 ◽

pp. 61-78 ◽

Cited By ~ 1

Author(s):

Muhammad Nasar Sayeed Khan ◽

Muhammad Iqbal Afridi ◽

Afzel Javed

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Life Expectancy ◽

Memory Loss ◽

Developed Countries ◽

World Health ◽

Average Life Expectancy ◽

People With Dementia ◽

Health Organization ◽

Number Of Individuals

Pakistan is one of the largest and most populated nations of South Asia and ranked sixth among the most crowded countries in the world, with a population exceeding 196 million. Because of a lack of research and the cultural setting, it is exceptionally hard to obtain an exact number of individuals suffering from dementia. However, the extrapolated prevalence of people with dementia in Pakistan is around 200,000. Compared to developed countries, only 4.2% of the Pakistani population are aged above 65 years, possibly due to an average life expectancy of 66 years for both genders . Although no specific data on elderly people with dementia in Pakistan are available, it is estimated that 8–10% of the general population aged above 65 years suffer from chronic memory loss. According to the latest 2014 World Health Organization data, Alzheimer’s disease/dementia-related deaths in Pakistan reached a total of 1776 or 0.16% of total deaths. Pakistan currently has the largest generation of young people ever recorded in its history, who will be at risk for dementia and Alzheimer’s disease by 2050, at which time, life expectancy would be expected to continue rising. Thus, the economic burden of treating patients with Alzheimer’s disease and other types of dementia will increase considerably.

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Alzheimer’s Disease: Special Focus on the Efficacy of Computer-Based Training Programs - A Mini-Review

Current Alzheimer Research ◽

10.2174/1567205015666180925105902 ◽

2018 ◽

Vol 15 (13) ◽

pp. 1213-1219 ◽

Cited By ~ 1

Author(s):

Blanka Klimova ◽

Kamil Kuca ◽

Petra Maresova

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Information Technologies ◽

Training Programs ◽

Developed Countries ◽

Special Focus ◽

Computer Based Training ◽

Computer Based ◽

The Developed Countries

Background: At present, the number of older people is growing, especially in the developed countries where the living conditions enable a longer life expectancy. However, the higher age may result in the aging diseases such as dementia out which Alzheimer’s disease (AD) is the most frequent. Nevertheless, to maintain them both physically and mentally active, more assistance is required. Objective: The purpose of this study is to discuss the efficacy of the use of modern information technologies, especially computer-based training programs, on people with Alzheimer’s disease (AD). Results: Although the results from the selected studies do not indicate that the computer-based training programs are effective in the delay of cognitive decline is concerned, they suggest that these computerbased training programs are at least appropriate for the improvement of their behavioural symptoms and progression of the disease. Conclusion: Generally, these technological devices may contribute to the reduction of patients´ and their caregivers´ costs and certain flexibility, and thus the improvement of the quality of their life.

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Economic burden of work injuries and diseases: a framework and application in five European Union countries

BMC Public Health ◽

10.1186/s12889-020-10050-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emile Tompa ◽

Amirabbas Mofidi ◽

Swenneke van den Heuvel ◽

Thijmen van Bree ◽

Frithjof Michaelsen ◽

...

Keyword(s):

European Union ◽

The Netherlands ◽

Economic Burden ◽

National Level ◽

Health And Safety ◽

Indirect Costs ◽

The European Union ◽

Work Injuries ◽

European Union Countries ◽

Related Quality

Abstract Background Estimates of the economic burden of work injuries and diseases can help policymakers prioritize occupational health and safety policies and interventions in order to best allocate scarce resources. Several attempts have been made to estimate these economic burdens at the national level, but most have not included a comprehensive list of cost components, and none have attempted to implement a standard approach across several countries. The aim of our study is to develop a framework for estimating the economic burden of work injuries and diseases and implement it for selected European Union countries. Methods We develop an incidence cost framework using a bottom-up approach to estimate the societal burden of work injuries and diseases and implement it for five European Union countries. Three broad categories of costs are considered—direct healthcare, indirect productivity and intangible health-related quality of life costs. We begin with data on newly diagnosed work injuries and diseases from calendar year 2015. We consider lifetime costs for cases across all categories and incurred by all stakeholders. Sensitivity analysis is undertaken for key parameters. Results Indirect costs are the largest part of the economic burden, then direct costs and intangible costs. As a percentage of GDP, the highest overall costs are for Poland (10.4%), then Italy (6.7%), The Netherlands (3.6%), Germany (3.3%) and Finland (2.7%). The Netherlands has the highest per case costs (€75,342), then Italy (€58,411), Germany (€44,919), Finland (€43,069) and Poland (€38,918). Costs per working-age population are highest for Italy (€4956), then The Netherlands (€2930), Poland (€2793), Germany (€2527) and Finland (€2331). Conclusions Our framework serves as a template for estimating the economic burden of work injuries and diseases across countries in the European Union and elsewhere. Results can assist policymakers with identifying health and safety priority areas based on the magnitude of components, particularly when stratified by key characteristics such as industry, injury/disease, age and sex. Case costing can serve as an input into the economic evaluation of prevention initiatives. Comparisons across countries provide insights into the relevant performance of health and safety systems.

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Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer's Disease in China (CPAD) study

International Psychogeriatrics ◽

10.1017/s1041610215000940 ◽

2015 ◽

Vol 28 (2) ◽

pp. 211-219 ◽

Cited By ~ 12

Author(s):

Mei Zhao ◽

Xiaozhen Lv ◽

Maimaitirexiati Tuerxun ◽

Jincai He ◽

Benyan Luo ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Family History ◽

Clinical Pathway ◽

Help Seeking ◽

Univariate Analysis ◽

Positive Family History ◽

Dementia Care ◽

Factors Associated ◽

People With Dementia

ABSTRACTBackground:The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.Methods:Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.Results:The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p= 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p< 0.001). Subtypes of dementia (p< 0.001), family history (p= 0.01), and education level (p= 0.03) were associated with the increased delay in help seeking.Conclusions:In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.

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Diet, nutrients and metabolism: cogs in the wheel driving Alzheimer's disease pathology?

British Journal Of Nutrition ◽

10.1017/s0007114515000926 ◽

2015 ◽

Vol 113 (10) ◽

pp. 1499-1517 ◽

Cited By ~ 19

Author(s):

Rhona Creegan ◽

Wendy Hunt ◽

Alexandra McManus ◽

Stephanie R. Rainey-Smith

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Symptoms ◽

Aged Care ◽

Ageing Population ◽

People With Dementia ◽

Stage Disease ◽

Custodial Care ◽

Global Statistics ◽

End Stage

Alzheimer's disease (AD), the most common form of dementia, is a chronic, progressive neurodegenerative disease that manifests clinically as a slow global decline in cognitive function, including deterioration of memory, reasoning, abstraction, language and emotional stability, culminating in a patient with end-stage disease, totally dependent on custodial care. With a global ageing population, it is predicted that there will be a marked increase in the number of people diagnosed with AD in the coming decades, making this a significant challenge to socio-economic policy and aged care. Global estimates put a direct cost for treating and caring for people with dementia at $US604 billion, an estimate that is expected to increase markedly. According to recent global statistics, there are 35·6 million dementia sufferers, the number of which is predicted to double every 20 years, unless strategies are implemented to reduce this burden. Currently, there is no cure for AD; while current therapies may temporarily ameliorate symptoms, death usually occurs approximately 8 years after diagnosis. A greater understanding of AD pathophysiology is paramount, and attention is now being directed to the discovery of biomarkers that may not only facilitate pre-symptomatic diagnosis, but also provide an insight into aberrant biochemical pathways that may reveal potential therapeutic targets, including nutritional ones. AD pathogenesis develops over many years before clinical symptoms appear, providing the opportunity to develop therapy that could slow or stop disease progression well before any clinical manifestation develops.

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Longitudinal study of medication use in caregivers of people with Alzheimer’s disease – Kuopio ALSOVA study

Dementia ◽

10.1177/1471301218802675 ◽

2018 ◽

Vol 19 (5) ◽

pp. 1573-1585

Author(s):

Tarja Välimäki ◽

Julia FM Gilmartin-Thomas ◽

J Simon Bell ◽

Tuomas Selander ◽

Anne M Koivisto

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Family Caregivers ◽

Social Insurance ◽

Medication Use ◽

Self Report ◽

Rank Test ◽

Kappa Statistics ◽

Prescription Register ◽

People With Dementia

Background The longitudinal pattern of medication use among family caregivers of people with dementia is not well understood, despite the potential for medication over- or under-use. Objectives To investigate caregiver medication use over a five-year follow-up using data obtained via self-report and from a national prescription register, and compare agreement between medication data obtained from the two sources. Methods Medication data for 222 family caregivers of people with Alzheimer’s disease were obtained via self-report and from the Finnish Social Insurance Institution. Generalised estimating equations, Kappa statistics and related samples Wilcoxon signed rank test were used to analyse medication use over time. Results The mean number of medications used by caregivers increased from 3.4 to 4.1 (self-reported current regular medications) and 2.4 to 2.8 (reimbursed prescription medications during the past 90 days) over five years (p < 0.001). Significantly, more medications were identified via self-report (mean 3.6, SD = 3.3) than the national prescription register (mean 2.6, SD = 2.4, Z= –12.300, p < 0.001). Agreement between the two data sources was good for cardiovascular medications and anti-hypertensives (Kappa = 0.883–0.967, p < 0.001) and medications for acid-related disorders (Kappa = 0.508–0.092, p < 0.001). Agreement was moderate for analgesics (Kappa = 0.281–0.477, p < 0.001) and psychotropics (Kappa = 0.281–0.562, p < 0.002). The proportion of caregivers using five or more medications increased from 27.5% to 44.6% (self-report), and 16.7% to 27.7% (register) (p < 0.001). Conclusion Caregivers use an increasing number of medications in the first five years of caring for persons with dementia, and self-report using a higher number of medications than data from the national prescription register suggest.

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Cross-cultural adaptation of the German version of the Quality of Life in Alzheimer's Disease scale - Nursing Home version (QoL-AD NH)

International Psychogeriatrics ◽

10.1017/s1041610216000107 ◽

2016 ◽

Vol 28 (8) ◽

pp. 1399-1400 ◽

Cited By ~ 6

Author(s):

Martin Nikolaus Dichter ◽

Eva-Maria Wolschon ◽

Gabriele Meyer ◽

Sascha Köpke

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Community Dwelling ◽

Positive Effects ◽

People With Dementia ◽

The Us ◽

Dementia Research ◽

Almost All

Dementia is a chronic and currently incurable syndrome. Therefore, quality of life (QoL) is a major goal when caring for people with dementia (Gibson et al., 2010) and a major outcome in dementia research (Moniz-Cook et al., 2008). The measurement of QoL, especially proxy-rating, is challenging because of the proxy-perspective (Pickard and Knight, 2005), reliability (Dichter et al., 2016), validity (O'Rourke et al., 2015), and responsiveness (Perales et al., 2013). Probably due to these challenges, it has not been possible to show positive effects for QoL in almost all non-pharmacological interventions for people with dementia (Cooper et al., 2012). One recommended (Moniz-Cook et al., 2008) and frequently used instrument is the Quality of Life in Alzheimer's Disease scale (QoL-AD), which was originally developed in the US for community-dwelling people with dementia. The QoL-AD consists of 13 items based on a 4-point Likert scale ranging from “1”=poor to “4”=excellent (Logsdon et al., 1999). The original instrument has been adapted for people living in nursing homes (NH) by Edelmann et al. (2005).

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