BACKGROUND: New effective treatments for dementia are lacking, and early prevention focusing on risk factors of dementia is important. Non-pharmacological intervention therapies aimed at these factors may provide a valuable tool for reducing the incidence of dementia. This study focused on the development of a mathematical model to predict the number of individuals with neurodegenerative diseases, specifically Alzheimer's disease, Parkinson's disease, vascular dementia, and amyotrophic lateral sclerosis. Scenarios for non-pharmacological intervention therapies based on risk factor reduction were also assessed. The estimated total costs and potential cost savings from societal were included. METHODS: Based on demographic and financial data from the EU, a mathematical model was developed to predict the prevalence and resulting care costs of neurodegenerative diseases in the population. Each disease (Alzheimer's disease, Parkinson's disease, vascular dementia, and amyotrophic lateral sclerosis) used parameters that included prevalence, incidence, and death risk ratio, and the simulation is related to the age of the cohort and the disease stage. RESULTS: A replicable simulation for predicting the prevalence and resulting cost of care for neurodegenerative diseases in the population exhibited an increase in treatment costs from 267 billion EUR in 2021 to 528 billion EUR by 2050 in the EU alone. Scenarios related to the reduction of the prevalence of dementia by up to 20% per decade led to total discounted treatment cost savings of up to 558 billion EUR. CONCLUSION: The model indicates the magnitude of the financial burden placed on EU healthcare systems due to the growth in the population prevalence of neurodegenerative diseases in the coming decades. Lifestyle interventions based on reducing the most common risk factors could serve as a prevention strategy to reduce the incidence of dementia with substantial cost-savings potential. These findings could support the implementation of public health approaches throughout life to ultimately prevent premature mortality and promote a healthier and more active lifestyle in older individuals.

Andalusian Research Institute in Data Science and Computational Intelligence University of Granada Granada 18071 Spain

Biomedical Research Centre University Hospital Hradec Kralove Hradec Kralove 50005 Czech Republic

Faculty of Informatics and Management University of Hradec Kralove Rokitanského 62 Hradec Kralove 50003 Czech Republic

Slovak University of Technology Bratislava 81237 Slovakia

See more in PubMed

Boada M, Peña-Casanova J, Bermejo F, Guillén F, Hart WM, Espinosa C, et al. [Costs of health care resources of ambulatory-care patients diagnosed with Alzheimer’s disease in Spain] Med Clin (Barc) 1999;113(18):690–5. PubMed

Ernst RL. Cognitive function and the costs of Alzheimer Disease: an exploratory study. Arch Neurol. 1997;54(6):687. doi: 10.1001/archneur.1997.00550180013006. PubMed DOI

Cimler R, Maresova P, Kuhnova J, Kuca K. Predictions of Alzheimer’s disease treatment and care costs in European countries. PLoS ONE. 2019;14(1):e0210958. doi: 10.1371/journal.pone.0210958. PubMed DOI PMC

Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63. doi: 10.1016/j.jalz.2012.11.007. PubMed DOI

Ikeda M, Mori E, Matsuo K, Nakagawa M, Kosaka K. Donepezil for dementia with Lewy bodies: a randomized, placebo-controlled, confirmatory phase III trial. Alzheimers Res Ther. 2015;7(1):4. doi: 10.1186/s13195-014-0083-0. PubMed DOI PMC

Gustavsson A, Green C, Jones RW, Förstl H, Simsek D, Reydet de Vulpillieres F, et al. Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer’s disease. Alzheimers Dement. 2017;13(3):312–21. doi: 10.1016/j.jalz.2016.12.005. PubMed DOI

Maresova P, Mohelska H, Dolejs J, Kuca K. Socio-economic aspects of Alzheimer’s Disease. Curr Alzheimer Res. 2015;12(9):903–11. doi: 10.2174/156720501209151019111448. PubMed DOI

Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. 2011;10(9):819–28. doi: 10.1016/S1474-4422(11)70072-2. PubMed DOI PMC

Vellas B, Coley N, Ousset PJ, Berrut G, Dartigues JF, Dubois B, et al. Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer’s disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol. 2012;11(10):851–9. doi: 10.1016/S1474-4422(12)70206-5. PubMed DOI

Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788–94. doi: 10.1016/S1474-4422(14)70136-X. PubMed DOI

O’Neil ME, Freeman M, Christensen V, Telerant R, Addleman A, Kansagara D. A Systematic Evidence Review of Non-pharmacological Interventions for Behavioral Symptoms of Dementia [Internet]. Washington (DC): Department of Veterans Affairs; 2011 [cited 2022 Apr 2]. (VA Evidence-based Synthesis Program Reports). http://www.ncbi.nlm.nih.gov/books/NBK54971/. PubMed

Beeri MS, Goldbourt U. Late-Life Dementia predicts mortality beyond established midlife risk factors. Am J Geriatr Psychiatry. 2011;19(1):79–87. doi: 10.1097/JGP.0b013e3181e043d0. PubMed DOI PMC

Lönnroos E, Kyyrönen P, Bell JS, van der Cammen TJM, Hartikainen S. Risk of death among persons with Alzheimer’s disease: a National Register-based nested case-control study. J Alzheimers Dis. 2013;33(1):157–64. doi: 10.3233/JAD-2012-120808. PubMed DOI

Georges J. Dementia in Europe Yearbook 2019 [Internet]. Alzheimer Europe; 2019. https://www.alzheimer-europe.org/sites/default/files/alzheimer_europe_dementia_in_europe_yearbook_2019.pdf.

World Alzheimer Report 2015, The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends.:87.

Davis M, O`Connell T, Johnson S, Cline S, Merikle E, Martenyi F, et al. Estimating Alzheimer’s Disease Progression Rates from normal cognition through mild cognitive impairment and stages of Dementia. Curr Alzheimer Res. 2018;15(8):777–88. doi: 10.2174/1567205015666180119092427. PubMed DOI PMC

Macleod AD, Taylor KSM, Counsell CE. Mortality in Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2014;29(13):1615–22. doi: 10.1002/mds.25898. PubMed DOI

Pringsheim T, Jette N, Frolkis A, Steeves TDL. The prevalence of Parkinson’s disease: a systematic review and meta-analysis. Mov Disord off J Mov Disord Soc. 2014;29(13):1583–90. doi: 10.1002/mds.25945. PubMed DOI

Hirsch L, Jette N, Frolkis A, Steeves T, Pringsheim T. The incidence of Parkinson’s Disease: a systematic review and Meta-analysis. Neuroepidemiology. 2016;46(4):292–300. doi: 10.1159/000445751. PubMed DOI

Enders D, Balzer-Geldsetzer M, Riedel O, Dodel R, Wittchen HU, Sensken SC, et al. Prevalence, duration and severity of Parkinson’s Disease in Germany: a combined Meta-analysis from Literature Data and Outpatient samples. Eur Neurol. 2017;78(3–4):128–36. doi: 10.1159/000477165. PubMed DOI

Garcia-Ptacek S, Farahmand B, Kåreholt I, Religa D, Cuadrado ML, Eriksdotter M. Mortality risk after Dementia diagnosis by dementia type and underlying factors: a cohort of 15,209 patients based on the Swedish Dementia Registry. J Alzheimers Dis. 2014;41(2):467–77. doi: 10.3233/JAD-131856. PubMed DOI

Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, et al. Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic diseases in the Elderly Research Group. Neurology. 2000;54(11 Suppl 5):S4–9. PubMed

Román GC. The Epidemiology of vascular dementia. In: Handbook of Clinical Neurology [Internet]. Elsevier; 2008 [cited 2022 May 17]. pp. 639–58. https://linkinghub.elsevier.com/retrieve/pii/S0072975207012596. PubMed

Coyle-Gilchrist ITS, Dick KM, Patterson K, Vázquez Rodríquez P, Wehmann E, Wilcox A, et al. Prevalence, characteristics, and survival of frontotemporal lobar degeneration syndromes. Neurology. 2016;86(18):1736–43. doi: 10.1212/WNL.0000000000002638. PubMed DOI PMC

Mayer F, Di Pucchio A, Lacorte E, Bacigalupo I, Marzolini F, Ferrante G, et al. An Estimate of attributable cases of Alzheimer Disease and Vascular Dementia due to modifiable risk factors: the impact of primary Prevention in Europe and in Italy. Dement Geriatr Cogn Disord Extra. 2018;8(1):60–71. doi: 10.1159/000487079. PubMed DOI PMC

Braun A, Kurzmann P, Höfler M, Haber G, Auer S. Cost of care for persons with dementia: using a discrete-time Markov chain approach with administrative and clinical data from the dementia service centres in Austria. Health Econ Rev. 2020;10(1):29. doi: 10.1186/s13561-020-00285-w. PubMed DOI PMC

Bruno G, Mancini M, Bruti G, Dell’Agnello G, Reed C, COSTS AND RESOURCE USE ASSOCIATED WITH ALZHEIMER’S DISEASE IN ITALY.: RESULTS FROM AN OBSERVATIONAL STUDY. J Prev Alzheimers Dis. 2017;1–10. PubMed

Holmerová I, Hort J, Rusina R, Wimo A, Šteffl M. Costs of dementia in the Czech Republic. Eur J Health Econ. 2017;18(8):979–86. doi: 10.1007/s10198-016-0842-x. PubMed DOI

Michalowsky B, Thyrian JR, Eichler T, Hertel J, Wucherer D, Flessa S, et al. Economic Analysis of Formal Care, Informal Care, and Productivity losses in primary care patients who screened positive for dementia in Germany. J Alzheimers Dis. 2015;50(1):47–59. doi: 10.3233/JAD-150600. PubMed DOI

Olazarán J, Agüera-Ortiz L, Argimón JM, Reed C, Ciudad A, Andrade P, et al. Costs and quality of life in community-dwelling patients with Alzheimer’s disease in Spain: results from the GERAS II observational study. Int Psychogeriatr. 2017;29(12):2081–93. doi: 10.1017/S1041610217001211. PubMed DOI

Rapp T, Andrieu S, Molinier L, Grand A, Cantet C, Mullins CD, et al. Exploring the relationship between Alzheimer’s Disease Severity and Longitudinal costs. Value Health. 2012;15(3):412–9. doi: 10.1016/j.jval.2012.02.003. PubMed DOI

Reese JP, Heßmann P, Seeberg G, Henkel D, Hirzmann P, Rieke J, et al. Cost and care of patients with Alzheimer’s Disease: clinical predictors in German Health Care settings. J Alzheimers Dis. 2011;27(4):723–36. doi: 10.3233/JAD-2011-110539. PubMed DOI

Wimo A, Reed CC, Dodel R, Belger M, Jones RW, Happich M, et al. The GERAS Study: a prospective observational study of costs and Resource Use in Community dwellers with Alzheimer’s Disease in three European Countries – Study Design and Baseline findings. J Alzheimers Dis. 2013;36(2):385–99. doi: 10.3233/JAD-122392. PubMed DOI

Findley L, Aujla M, Bain PG, Baker M, Beech C, Bowman C, et al. Direct economic impact of Parkinson’s disease: a research survey in the United Kingdom. Mov Disord. 2003;18(10):1139–45. doi: 10.1002/mds.10507. PubMed DOI

Hagell P, Nordling S, Reimer J, Grabowski M, Persson U. Resource use and costs in a Swedish cohort of patients with Parkinson’s disease. Mov Disord off J Mov Disord Soc. 2002;17(6):1213–20. doi: 10.1002/mds.10262. PubMed DOI

Keränen T, Kaakkola S, Sotaniemi K, Laulumaa V, Haapaniemi T, Jolma T, et al. Economic burden and quality of life impairment increase with severity of PD. Parkinsonism Relat Disord. 2003;9(3):163–8. doi: 10.1016/S1353-8020(02)00097-4. PubMed DOI

Lindgren P, von Campenhausen S, Spottke E, Siebert U, Dodel R. Cost of Parkinson’s disease in Europe. Eur J Neurol. 2005;12(s1):68–73. doi: 10.1111/j.1468-1331.2005.01197.x. PubMed DOI

McCrone P, Allcock LM, Burn DJ. Predicting the cost of Parkinson’s disease. Mov Disord. 2007;22(6):804–12. doi: 10.1002/mds.21360. PubMed DOI

von Campenhausen S, Winter Y, Rodrigues e Silva A, Sampaio C, Ruzicka E, Barone P, et al. Costs of illness and care in Parkinson’s Disease: an evaluation in six countries. Eur Neuropsychopharmacol. 2011;21(2):180–91. doi: 10.1016/j.euroneuro.2010.08.002. PubMed DOI

Winter Y, von Campenhausen S, Brozova H, Skoupa J, Reese JP, Bötzel K, et al. Costs of Parkinson’s disease in Eastern Europe: a Czech cohort study. Parkinsonism Relat Disord. 2010;16(1):51–6. doi: 10.1016/j.parkreldis.2009.07.005. PubMed DOI

Athanasakis K, Kyriopoulos II, Sideris M, Rentzos M, Evdokimidis J, Kyriopoulos J. Investigating the economic burden of ALS in Greece: a cost-of-illness approach. Amyotroph Lateral Scler Front Degener. 2015;16(1–2):63–4. doi: 10.3109/21678421.2014.932384. PubMed DOI

Darbà J. Current status and direct medical cost of amyotrophic lateral sclerosis in the region of Catalonia: a population-based analysis. PLoS ONE. 2019;10(10):e0223772. doi: 10.1371/journal.pone.0223772. PubMed DOI PMC

Schepelmann K, Winter Y, Spottke AE, Claus D, Grothe C, Schröder R, et al. Socioeconomic burden of amyotrophic lateral sclerosis, myasthenia gravis and facioscapulohumeral muscular dystrophy. J Neurol. 2010;257(1):15–23. doi: 10.1007/s00415-009-5256-6. PubMed DOI

Schönfelder E, Osmanovic A, Müschen LH, Petri S, Schreiber-Katz O. Costs of illness in amyotrophic lateral sclerosis (ALS): a cross-sectional survey in Germany. Orphanet J Rare Dis. 2020;15(1):149. doi: 10.1186/s13023-020-01413-9. PubMed DOI PMC

Steen IVD, Berg JPVD, Buskens E, Lindeman E, Van Den Berg LH. The costs of amyotrophic lateral sclerosis, according to type of care. Amyotroph Lateral Scler. 2009;10(1):27–34. doi: 10.1080/17482960802103131. PubMed DOI

Ramos–Estebanez C, Moral–Arce I, Rojo F, Gonzalez–Macias J, Hernandez JL. Vascular cognitive impairment and dementia expenditures: 7–Year inpatient cost description in Community dwellers. Postgrad Med. 2012;124(5):91–100. doi: 10.3810/pgm.2012.09.2597. PubMed DOI

Eurostat. Statistics | Eurostat [Internet]. [cited 2023 Apr 29]. https://ec.europa.eu/eurostat/databrowser/view/SDG_08_10__custom_5679006/default/table?lang=en.

Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer’s disease. Alzheimers Dement. 2007;3(3):186–91. doi: 10.1016/j.jalz.2007.04.381. PubMed DOI

Aldus CF, Arthur A, Dennington-Price A, Millac P, Richmond P, Dening T et al. Discussion [Internet]. Undiagnosed dementia in primary care: a record linkage study. NIHR Journals Library; 2020 [cited 2022 May 17]. https://www.ncbi.nlm.nih.gov/books/NBK555879/. PubMed

Pedroza P, Chakrabarti S, Chapin A, Liu A, Matyasz T, Dieleman JL. COSTS OF ALZHEIMER’S DISEASE AND DEMENTIA IN 188 COUNTRIES. Alzheimers Dement. 2019;15(7):P1635.

Eurostat. Eurodindicators [Internet]. Eurostat. 2022. https://ec.europa.eu/eurostat/documents/2995521/14442438/2-01042022-AP-EN.pdf/ba153bc6-c1aa-f6e5-785b-21c83f5319e5.

Custodio N, Montesinos R, Lira D, Herrera-Pérez E, Bardales Y, Valeriano-Lorenzo L. Mixed dementia: a review of the evidence. Dement Neuropsychol. 2017;11(4):364–70. doi: 10.1590/1980-57642016dn11-040005. PubMed DOI PMC

Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, Bäckman L, Hänninen T, Jula A, Laatikainen T, Lindström J, Mangialasche F, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385:2255–63. doi: 10.1016/S0140-6736(15)60461-5. PubMed DOI

Finnisch Institute for health and welfare. FINGER research project results. https://thl.fi/en/research-and-development/research-and-projects/finger-research-project/results.

van Moll EP, Richard E, Eurelings LS, et al. Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial. Lancet. 2016;388(10046):797–805. doi: 10.1016/S0140-6736(16)30950-3. PubMed DOI

Vellas B, Carrie I, Gillette-Guyonnet S, et al. MAPT study: a multidomain approach for preventing Alzheimer’s disease: design and baseline data. J Prev Alzheimers Dis. 2014;1(1):13–22. PubMed PMC

Delrieu J, Vellas B, Guyonnet S, et al. Cognitive impact of multidomain intervention and omega 3 according to blood Aβ42/40 ratio: a subgroup analysis from the randomized MAPT trial. Alz Res Therapy. 2023;15:183. doi: 10.1186/s13195-023-01325-3. PubMed DOI PMC

Food and Agriculture Organization. Cost and affordability of a healthy diet: an update. 2022. https://www.fao.org/3/cc0639en/online/sofi-2022/cost-affordability-healthy-diet.html.

Hagberg LA, Lindholm L. Measuring the time costs of exercise: a proposed measuring method and a pilot study. Cost Eff Resour Alloc. 2010;8:9. doi: 10.1186/1478-7547-8-9. PubMed DOI PMC