{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:52:55Z","timestamp":1781841175345,"version":"3.54.5"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007753","name":"University of Eastern Finland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007753","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Health Econ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Alzheimer\u2019s disease (AD) accounts for a significant proportion of health and social care costs. We studied family caregiver (FC), care recipient (CR), and formal care provider-related factors, which are associated with the cost of care in different stages of AD in Finland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 5-year follow-up was conducted with 231 individuals with AD (CRs) and their FCs as a part of the ALSOVA project. The data was collected between 2002 and 06. Significant factors associated with costs were identified using a stepwise backward elimination procedure. Neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory (NPI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across all stages of AD, each additional year of CR\u2019s education was associated with a 3.4% reduction in costs (rate ratio [RR] 0.966, 95% CI 0.940\u20130.993). Conversely, a one-point increase on the Neuropsychiatric Inventory was associated with a 1.8% increase in costs (RR 1.018, 95% CI 1.011\u20131.025). CR\u2019s neuropsychiatric symptoms (RR 1.028, 95% CI 1.010\u20131.047) and male FC (RR 1.756, 95% CI 1.266\u20132.437) were associated with increased total costs in early AD, CR\u2019s comorbidities (RR 1.138, 95% CI 1.068\u20131.212) and FC\u2019s burden (RR 1.032, 95% CI 1.012\u20131.053) in mild AD and FC being a spouse (RR 1.451, 95% CI 1.105\u20131.905) in moderate AD. No formal care provider-related factors were associated with total costs in any stage of AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals several factors that may be manageable to control the costs of AD. Comprehensive prevention, evaluation, and treatment of a CR\u2019s neuropsychiatric symptoms and comorbidities should be executed early. Informal care can act as a substitute for formal care in early-stage AD, and supportive measures toward FCs should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10198-026-01950-3","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:12:30Z","timestamp":1781838750000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Different family caregiver- and care recipient-related factors are associated with the cost of care in the early, mild, and moderate stages of Alzheimer\u2019s disease in Finland: A 5-year ALSOVA study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2095-4453","authenticated-orcid":false,"given":"Viivi","family":"Jetsonen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarja","family":"V\u00e4lim\u00e4ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas","family":"Selander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virpi","family":"Kuvaja-K\u00f6llner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne","family":"Martikainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Koivisto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"1950_CR1","unstructured":"WHO. 2021. 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In addition, the Finnish Social and Health Ministry (STM) and the THL accepted the study (original permission STM\/62\/07\/2000, updated regularly, last time by THL on 2023 Dnro THL\/1576\/5.05.00\/2014). Both oral and written informed consent were received from the FCs and CRs.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Janne Martikainen is a founding partner of ESiOR Oy. This company was not involved in carrying out this research. The other authors declare that they have no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}