Alzheimer's disease (AD) is one of the most widely known of
the organic
mental disorders described as dementias. It is apparent, in both the USA
and
the UK, that AD imposes a large economic burden in terms of both formal
and
informal costs. In the UK, one estimate is that annual costs are about
£1,039
million at 1990/91 prices and another, even higher, at £4,684
million. There
is an extremely heavy burden on informal caregivers, and on agencies
providing social services and residential accommodation.
After the onset of AD, the progress of the illness results in declining
levels of
functioning and increased dependency for patients, factors linked to higher
needs for care. Evidence from clinical trials indicates that some drugs
may
retard the effects of this decline. Economic evaluation of treatments has
focused on drug therapies and their ability to alter this progress. One
suggestion is that, through delaying the decline and consequent institutionalisation
of the patient, effective drug therapy would have economic
benefits and reduce health service costs, but this point has not been clearly
demonstrated and is open to question.