Affiliations: Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
Correspondence:
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Correspondence to: Lan Gao, PhD, Deakin Health Economics, Institute for Health, Transformation, Faculty of Health, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia. Tel.: +61 613 9244 5533; Fax: +61 613 9244 6624; E-mail: lan.gao@deakin.edu.au.
Note: [1] These authors contributed equally to this work.
Abstract: Background:The established link between cardiovascular disease (CVD) and dementia may provide new insights into dementia prevention. Objective:It aims to quantify the burden of dementia attributable to people with CVD. Methods:A Markov microsimulation model was developed to simulate the lifetime cost and quality-adjusted life-years (QALYs) related to people with and without CVD in Australia. A de-novo systematic review was undertaken to identify all evidence around the association between CVD [i.e., stroke, myocardial infarction (MI), atrial fibrillation (AF), and heart failure (HF)] and the risk of developing dementia. Incremental costs and QALY losses were estimated for people by type of CVD compared to the general Australian population without CVD. Results:Of the comprehensive literature search, 19 observational studies were included in the qualitative synthesis. Patients who had CVD incurred both higher healthcare costs over their lifetime (ranging from $73,131 for patients with AF to $127,396 for patients with HF) and fewer QALYs gains (from –1.099 for patients with MI to –5.163 for patients with stroke), compared to people who did not have CVD. The total incremental economic burden of dementia from patients aged 65 years and over with CVD was $6.45 billion (stroke), $11.89 billion (AF), $17.57 billion (MI), or $7.95 billion (HF) over their remaining life expectancy. Conclusion:The results highlighted the importance of CVD prevention to reduce the CVD burden and decrease the prevalence of dementia. Interventions that target patients with dementia risk factors like CVD may prove to be effective and cost-effective strategies.
Keywords: Burden of disease, cardiovascular disease, dementia, meta-analysis, systematic review
