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Economic evaluation of technology-based interventions for people with dementia care support and their caregivers: Current situation
Published on 30 September 2023

Dementia carries significant social and economic implications, encompassing the direct expenses of medical and social care, along with the costs associated with informal caregiving. In 2019, those providing informal care, typically family members and friends, dedicated an average of 5 hours daily to support individuals with dementia. Within the same year, the global societal cost of dementia reached an estimated US$ 1.3 trillion, and projections indicate these expenses will rise to over US$ 2.8 trillion by 2030 [1]. This increase is anticipated due to both the growing number of people affected by dementia and escalating care-related expenditures. It is important to emphasize the economic impact, particularly on informal caregivers, who predominantly care for individuals residing in their homes.

Informal care in dementia

The impact of informal care in dementia, specifically, constitutes approximately 50% of global costs, sometimes surpassing direct costs [2]. Engaging caregivers in care planning and considering the preferences of individuals with dementia and their families is imperative due to the necessity of addressing the care of these individuals and the associated caregiver burden.

Furthermore, ensuring the continuity of care across various providers, sectors, and system levels, along with fostering active collaboration between paid and unpaid caregivers, is essential. This collaboration should span from the initial onset of dementia symptoms to the end of life. Integrated, evidence-based, person-centered care is a fundamental requirement in all environments where individuals with dementia reside, particularly in their homes and within the community.

To enhance the overall care journey, from risk reduction to end of life, systematic monitoring and evaluation of health and social care system utilization are crucial. This approach can offer the most reliable evidence for policy and service development, subsequently improving prevention, accessibility, and coordination of care for individuals with dementia.

Health interventions delivered through digital tecnologies

In recent times, there has been a notable rise in the utilization of health interventions [3] delivered through digital technologies, including smartphones, web-based resources, and text messages. The purpose of employing these technologies is to facilitate remote access to efficacious treatments, enhance the management of chronic pathologies, and advocate for healthier lifestyles. This trend aims to either increase or supplant conventional health interventions . Concerning dementia, a recent systematic review and meta-analysis focusing on internet-based support interventions for family caregivers of individuals with dementia have determined that these interventions are generally effective. They demonstrate improvements in depressive symptoms, perceived stress, anxiety, and self-efficacy among caregivers. Moreover, these interventions show potential benefits for the ultimate recipients of care [4].

Economic evaluation of health interventions for the management of conditions of elderly multimorbid patients with dementia

The existing body of literature ( FamTechCare, LIVE@Home.Path, D-CARE, Namaste Care Family program, BeyondSilos, TV-AssistDem, PARO ) pertaining to the effectiveness evaluation of health interventions for the management of this population based on technologies is limited. Furthermore, considerable heterogeneity is evident among these interventions, both in terms of their design—typically characterized by a multicomponent approach addressing the needs of individuals with dementia and their caregivers—and their assessment methodologies, incorporating diverse outcome measures and targeting populations with varying degrees of dementia severity. This heterogeneity poses challenges in comparing and synthesizing the outcomes of these interventions.

  1. Global action plan on the public health response to dementia 2017–2025. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
  2. Wimo A, Seeher K, Cataldi R, Cyhlarova E, Dielemann JL, Frisell O, Guerchet M, Jönsson L, Malaha AK, Nichols E, Pedroza P, Prince M, Knapp M, Dua T. The worldwide costs of dementia in 2019. Alzheimers Dement. 2023 Jul;19(7):2865-2873. doi: 10.1002/alz.12901.
  3. Gomes M, Murray E, Raftery J. Economic Evaluation of Digital Health Interventions: Methodological Issues and Recommendations for Practice. Pharmacoeconomics. 2022 Apr;40(4):367-378
  4. Leng M, Zhao Y, Xiao H, Li C, Wang Z. Internet-based supportive interventions for family caregivers of people with dementia: systematic review and meta-analysis. J Med Internet Res. 9 Sep 2020; 22(9):e19468. doi: 10.2196/19468. PMID: 32902388; PMCID: PMC7511858.