Microsimulation Modeling to Compare the Effectiveness and Cost-Effectiveness of Nondrug Interventions to Manage Clinical Symptoms in Racially/Ethnically Diverse Persons with Dementia

Abstract

Alzheimer’s disease and related disorders (ADRD) affects >5 million Americans, disproportionately impacts minority populations, and has significant economic consequences. Systematic reviews of randomized trials conclude that nondrug dyadic interventions that engage the person with ADRD and provide caregivers with skills effectively maintain or slow functional decline and/or reduce ADRD-related behaviors; however, it is unclear as to the effects of these proven programs on outcomes of relevance to families and policymakers not included in the original trials. Using our published ADRD microsimulation model, our proposed study will evaluate the effectiveness, cost-effectiveness, and affordability of nondrug ADRD interventions on four family and health policy outcomes (family hours caregiving, days in a nursing home, costs to families/Medicaid/ Medicare, and quality-adjusted life-years of persons with ADRD and their caregivers), will provide an understanding of how differential access to interventions by race (African American, Asian, and White) and ethnicity (Hispanic) impacts outcomes, and will determine which ADRD interventions should be tested in additional trials.