Clinico-economical Effect of Drug Therapy for Behavioral Problems in Dementia

Abstract

Patients with dementia frequently show abnormal behaviors such as wandering, sleep disturbance, etc. These symptoms are recently referred to as behavioral and psychological symptoms of dementia (BPSD), which are a major burden for family and caregivers. Increasing medical expenses are one of the major economic problems in developed countries. Although various anti-psychotic drugs have been used for treatment of the BPSD, the clinical economic analysis of such drugs has not been fully performed. To evaluate the cost-benefit of anti-psychotic drugs in the treatment of BPSD for institutionalized patients with dementia, the daily sleep and wake patterns of sixty six patients with Alzheimer's disease (AD) in a geriatric institution were visually monitored on an hourly basis for 7 consecutive days. After randomly dividing the sixty six patients into two groups, a low dose of risperidone, an anti-psychotic drug, was administered for the thirty four patients, especially those manifesting wandering behavior. After a small dose of risperidone, that cost less than ＄0.50 per person per day, the mean wandering hours decreased by 2 hours per day. The decreased wandering of the patients alleviated the caregivers' burden, allowing them to devote more time to other work, a savings of at least ＄15.00 per caregiver per day. The appropriate use of anti-psychotic drugs in the treatment of wandering of AD patients can decrease the caregivers' working hours, worth at least ＄15.00 per caregiver per day in Japan.