Revue de neuropsychologie


Proof of concept of a cost-utility analysis for treatment by cognitive rehabilitation in early dementia Volume 4, issue 3, Juillet-Août-Septembre 2012


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Centre de la mémoire, CHU de Liège Centre-Ville, quai Godefroid Kurth, 45, 4020 Liège, Belgique, Service d’informations médico-économiques (SIME), CHU de Liège, B35 Sart Tilman, 4000 Liège, Belgique, Département de santé publique, d’épidémiologie et d’économie de la santé, université de Liège, avenue de l’Hôpital 3, B23, 4000 Liège, Belgique

Cognitive rehabilitation for patients with early Alzheimer's disease aims to help the patient performing a specific task bypassing the operating deficits while using residual cognitive abilities. To date, no economic evaluation has yet demonstrated the efficiency of this type of care. We have included in this study 17 patients with early degenerative dementia. Nine have received cognitive rehabilitation in addition to pharmacological treatment and eight were treated only by medication. The follow up was fixed at the rate of a quarterly visit to the informal caregiver, at 3, 6, 9 and 12 months to collect the direct costs related to the disease and implement a questionnaire to assess utility values related to the treatment. Participants were enrolled sequentially over our study period of 15 months. 17 subjects were followed for 3 months, 12 for 6 months, 6 to 9 months and 3 for one year. The results of the cost-utility analysis at three months to six months follow-up suggest that cognitive rehabilitation is efficient for the patient and source of savings for health insurance and a health perspective overall. The analysis of nine and twelve months was not possible due to small sample sizes. Although there are many limitations to the study, these initial results suggest an economic interest of cognitive rehabilitation that needs to be confirmed by studies on larger populations.