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Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain

From the Planning and Evaluation Unit, Canary Health Service, Spain (J.L.-B., P.S.-A., L.P.-P.); University Hospital Nuestra Señora de la Candelaria, Tenerife, Canary Health Service, Spain (J.L.-B.); Carlos III University, Madrid, Spain (J.O.-M.); and Fundacion de Estudios de Economia Aplicada, Madrid, Spain (J.O.-M.).

Address correspondence and reprint requests to Dr. Julio Lopez-Bastida, C/ Perez de Rozas, 5. 4°. 38004-Santa Cruz de Tenerife, Spain; e-mail: jlopbas{at}gobiernodecanarias.org

Objectives: To examine the economic burden (direct and indirect costs) of Alzheimer disease (AD) and to analyze the impact on health-related quality of life (HRQOL) for patients with AD and caregivers in 2001 in the Canary Islands, Spain.

Methods: Two hundred thirty-seven patients (61% of those contacted) were recruited from the Alzheimer’s Disease Association in the Canary Islands. Demographic, health resources utilization, informal care, indirect costs, and quality of life data were collected from primary caregivers of patients as proxy respondents. HRQOL was measured for patients and caregivers with the generic questionnaire EQ-5D.

Results: The average annual cost per patient with AD was 28,198 (US $36,144). The most important categories of costs were for informal care and drugs. Costs increased with cognitive impairment with an average annual cost of 14,956 (US $19,171) for mild, 25,562 (US $32,765) for moderate, and 41,669 (US $53,411) for severe patients. The total cost of patients with AD in Canary Islands was 259 (US $332) million. The HRQOL with the EQ-5D social tariff was 0.29 for patients and 0.67 for caregivers. The EQ-5D VAS (thermometer) score was 42 for patients and 62 for caregivers.

Conclusions: Direct health care costs of AD represented 2.4% of the total public health care expenditure in the Canary Islands. Across all severity levels, we estimated a total annual cost of 10 (US $13) billion for AD patients older than 65 years in Spain. The degree of severity of the patients with AD substantially influenced the quality of life of the patients but not that of the caregivers.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the December 26 issue to find the title link for this article.

Supported by a grant from FEDER, Health Institute Carlos III, Ministry of Health and Consumer Affairs (Expte.00/10043). The sponsor of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Authors’ contributions are listed on the Neurology Web site at www.neurology.org.

Disclosure: The authors report no conflicts of interest.

Received April 11, 2006. Accepted in final form September 13, 2006.