The economic burden of dementia in Europe: COIN-Eu dementia.

BackgroundDementia, with Alzheimer's disease as its most common underlying cause, is a major contributor to disability, dependency, and death, imposing significant societal and economic burdens across Europe. Despite its growing prevalence, cross-country cost estimates remain scarce and highly heterogeneous, limiting comparability.ObjectiveTo estimate country-level societal costs of dementia in Europe and to derive aggregate European cost estimates, including direct costs, indirect costs (productivity losses), and informal care costs.MethodsA standardized review of dementia cost assessments conducted in Europe was performed. Heterogeneous cost-estimation approaches were harmonized using pooling and health-economic imputation techniques to address data gaps and generate country-level estimates. All cost estimates were converted to 2019 euros using Consumer Price Indices and Purchasing Power Parities (PPP). Informal care costs were analyzed separately to reflect their complexity and substantial contribution to total costs.ResultsForty-five studies were identified. Annual societal costs of dementia in high-income European countries totaled €221.4 billion (€PPP, 2019; €25,218 per patient) for 8.8 million people with dementia. Informal care and direct costs accounted for 58% and 42% of total costs, respectively. Indirect costs contributed minimally to total costs. Substantial variation in per patient costs across countries was observed.ConclusionsDementia care imposes substantial societal burdens, largely driven by informal care. Owing to data availability, estimates were limited to high-income European countries. Future research should focus on standardizing cost assessment methods, improving informal care valuation, expanding evidence from low- and middle-income countries, and evaluating the financial impact of emerging treatments and prevention strategies.