Economic cost of Alzheimer disease in Israel.

The objective of this prospective study was to evaluate the cost of Alzheimer disease (AD) in Israel. Seventy-one AD patients who lived in the community, 50 institutionalized AD patients, both AD groups' respective primary caregivers, and 50 healthy elderly subjects were interviewed. The interviews covered information about the number of caregivers' hours invested in caring for the patient and amount of expenditures such as in house paid help and payments for day care. The annual social cost of caring for a person with AD in Israel was approximately $17,000, whether the patient lived at home or in a nursing home, but the cost components differed in the two groups. For community-dwelling patients, 60% of the cost represented an imputed value of unpaid indirect care compared with 12% for institutionalized patients. Also, in both residences, the private cost was significantly higher than the public cost, i.e., more 75% of the services provided to patients were paid out of pocket. Cost of institutionalization was the major component of the social cost. The cost of the disease increased with functional and cognitive deterioration for the community-dwelling group only. With projected increases in the number of persons at risk for developing AD, the economic impact of the disease on future costs will be significant. Efforts to delay deterioration and, as a result, delay institutionalization seem crucial for cost containment.