The effect of exercise interventions on reducing the need for caregivers in Parkinson's patients: An economic cost-effectiveness assessment

چکیده مقاله The effect of exercise interventions on reducing the need for caregivers in Parkinson's patients: An economic cost-effectiveness assessment Parkinson's disease (PD) is a progressive neurodegenerative disorder marked by motor and non-motor symptoms that often lead to increased dependency and the need for caregiver support. As the disease advances, informal and formal caregiving costs become a significant burden on families and healthcare systems. Exercise-based interventions have shown promise in improving physical function and reducing disability in PD, potentially delaying or reducing the need for caregiving. However, their impact from a cost-effectiveness perspective remains underexplored. This study aims to assess whether structured exercise interventions, such as resistance training, aerobic exercise, and balance-focused programs, can reduce the reliance on caregivers among individuals with Parkinson's disease. It also evaluates the economic cost-effectiveness of these interventions in terms of caregiver cost savings and improved patient independence. A comparative cost-effectiveness assessment was conducted based on data from peer-reviewed clinical trials, economic modeling studies, and Parkinson's disease registries published between 2000 and 2025. Outcome metrics included: changes in caregiver hours required per week, direct caregiver costs saved, improvements in independence (measured via ADL scales), and cost per unit reduction in caregiving needs. Economic models estimated incremental cost-effectiveness ratios (ICERS) and cost per quality-adjusted life year (QALY) gained with and without exercise interventions. Exercise interventions were associated with significant reductions in caregiver dependency, particularly in early- to mid-stage PD. Patients participating in structured resistance or multimodal exercise programs required 20%-40% fewer caregiver hours per week compared to non-exercising counterparts. Balance and gait training further contributed to reduced fall risk and increased self-efficacy in daily tasks. From an economic standpoint, these interventions produced net savings in caregiver costs ranging from $1,200 to $4,800 annually per patient, depending on intervention type, frequency, and delivery setting. ICERS for exercise interventions were within commonly accepted thresholds for cost-effectiveness, particularly when long-term reduction in caregiving dependency was factored into models. Exercise interventions not only improve physical outcomes in Parkinson's patients but also reduce their reliance on caregiver support translating into measurable economic savings. Resistance and multimodal training programs appear most effective in enhancing patient independence and lowering caregiver time requirements. Given the growing cost burden of caregiving in neurodegenerative diseases, integrating structured exercise programs into standard PD care may be a cost-effective strategy to delay functional decline and reduce societal and familial caregiving costs.