Zencir M, Kuzu N, Beşer N Gördeles, Ergin A, Catak B, Sahiner T
Pamukkale University Medical Faculty, Department of Public Health, Turkey.
Int J Geriatr Psychiatry. 2005 Jul;20(7):616-22. doi: 10.1002/gps.1332.
To evaluate the economic impact of AD in Denizli, Turkey.
This observational study was conducted with 42 AD patients and their primary caregivers. During the initial interview, demographic data and medical histories were collected with questionnaires. For an observational period of 15 days, data on time spent for patient care were collected using standard forms. Calculations on direct cost (e.g. per day medication, outpatient physician visits during the last 3 months), indirect cost (e.g. time spent for care by caregiver for daily living (ADL) and instrumental activity of daily living (IADL)) were made by summing up and taking averages of the appropriate items. ANOVA, and linear regressions were the methods for comparisons.
The primary caregivers of the patients mainly were their children and/or spouses. The maximum mean time spent (h/week) was 21.0 (17.5) for severely damaged cognition. The average annual cost per case was between $1,766 [95% Confidence Intervals (CI); 1.300-2.231] and $4,930 (95% CI; 3.3714-6.147). The amount of caregiver cost was the most significant item in the overall cost and it showed an increase with the declining cognitive function of patients. Daily medication cost reflected the same pattern. In contrast, cost of outpatient physician was the lowest among the patients with the worst cognition.
These results suggest that recently AD has become a significant cost for developing countries. This pilot study gives an idea of the cost of AD in developing countries where determining the actual cost can be difficult.
评估土耳其代尼兹利市阿尔茨海默病（AD）的经济影响。
本观察性研究对42例AD患者及其主要照料者进行。在初次访谈期间，通过问卷收集人口统计学数据和病史。在15天的观察期内，使用标准表格收集患者护理所花费时间的数据。通过汇总并计算适当项目的平均值，得出直接成本（如每日药物费用、过去3个月的门诊医生诊疗费用）和间接成本（如照料者用于日常生活活动（ADL）和工具性日常生活活动（IADL）的护理时间）。采用方差分析和线性回归进行比较。
患者的主要照料者主要是他们的子女和/或配偶。认知严重受损的患者，每周花费时间的最大平均值为21.0（17.5）小时。每例患者的年均成本在1766美元[95%置信区间（CI）；1300 - 2231]至4930美元（95%CI；3371 - 6147）之间。照料者成本在总成本中是最显著的项目，并且随着患者认知功能的下降而增加。每日药物费用呈现相同模式。相比之下，认知最差的患者门诊医生费用最低。
这些结果表明，最近AD已成为发展中国家的一项重大成本。这项初步研究让人们了解了在难以确定实际成本的发展中国家AD的成本情况。
