Personal wealth is associated with health care costs in people with Alzheimer’s disease

Finland has a strong public health care system; nevertheless, personal wealth is associated with the costs of hospital care and medication in people with Alzheimer’s disease. Higher levels of wealth were associated with greater costs of hospital care before the diagnosis, a new study from the University of Eastern Finland shows.

The study included 70,531 persons diagnosed with Alzheimer’s disease between 2005 and 2011, whose medication costs and costs of hospital care were compiled from Finland’s national registers. The researchers examined the costs over a seven-year period, which started five years before the Alzheimer’s diagnosis and ended two years after the diagnosis. The personal wealth indicators used in the study included taxable wealth, taxes and tax-like charges, and disposable income and current transfers received, on which data were obtained from Statistics Finland for 1995–2006.

Despite slight differences in the different wealth indicators, the study showed that people with higher levels of wealth also had higher health care costs before the Alzheimer’s diagnosis, which may be explained by better health awareness and earlier seeking of care. On the other hand, higher levels of wealth were associated with lower health care costs after the Alzheimer’s diagnosis, but this association was explained by differences in comorbidities across different wealth levels.

“Although the data are from more than ten years ago, the findings are of global interest, as they reveal the existence of health inequalities in a country that is traditionally considered to have strong public health care system. In addition, the association between personal wealth and costs of care among people with dementia has been studied surprisingly little. It would therefore be interesting and important to conduct the study on more recent data, and also to include other costs of treatment and care,” says Professor and Lead Author Anna-Maija Tolppanen of the University of Eastern Finland.

The study was carried out as part of the MEDALZ study at the University of Eastern Finland School of Pharmacy, which examined the health and use of medications in people with Alzheimer’s disease. Researchers from the Institute of Public Health and Clinical Nutrition at the University of Eastern Finland and from London School of Economics also contributed to the study.

The study was carried out on a grant awarded by the Social Insurance Institution of Finland. 

For further information, please contact: 

Professor Anna-Maija Tolppanen, University of eastern Finland, School of Pharmacy, anna-maija.tolppanen(a)uef.fi https://uefconnect.uef.fi/en/person/anna-maija.tolppanen/  

Research article: 

Rand Jarroch, Sirpa Hartikainen, Jussi Kauhanen, Martin Knapp, Anna-Maija Tolppanen. Association of Personal Wealth Indicators and Health Care Costs in Persons With Alzheimer's Disease. Journal of the American Medical Directors Association, Volume 24, Issue 12,2023, Pages 1974-1980, ISSN 1525-8610, https://doi.org/10.1016/j.jamda.2023.09.017

The paper is available as an open access article until 13 January 2024 at: https://www.sciencedirect.com/science/article/pii/S1525861023008216?dgcid=author