Ekman Mattias, Berg Jenny, Wimo Anders, Jönsson Linus, McBurney Christopher
Stockholm Health Economics, Stockholm, Sweden.
Int J Geriatr Psychiatry. 2007 Jul;22(7):649-55. doi: 10.1002/gps.1725.
To collect new primary data on community-based health utilities (time trade-off values) in different stages of mild cognitive impairment and dementia from a general population sample.
A cross-sectional study including 1,800 randomly selected members of the Swedish public aged 45-84 was performed through a postal survey; 42% response rate. The Clinical Dementia Rating scale was used for describing progressive stages of dementia in vignettes that were used in combination with time trade-off questions for valuing the perceived quality of life in these stages.
The time-trade off values varied considerably across the progressive disease stages. The mean score was 0.82 for mild cognitive impairment, 0.62 for mild dementia, 0.40 for moderate dementia, and 0.25 for severe dementia. In multiple regression analyses, the scores were relatively insensitive to demographic factors like age, gender and self-assessed health.
The results showed that the average time trade-off values declined sharply from mild cognitive impairment to progressing stages of dementia. Since there are many methodological challenges involved in measuring health state utilities in mild cognitive impairment and dementia, more research that evaluates different methods would be welcome.
从一般人群样本中收集关于轻度认知障碍和痴呆不同阶段基于社区的健康效用（时间权衡值）的新的原始数据。
通过邮政调查对1800名年龄在45 - 84岁的瑞典公众随机样本进行横断面研究；回复率为42%。临床痴呆评定量表用于描述病例 vignettes 中痴呆的进展阶段，这些 vignettes 与时间权衡问题相结合，以评估这些阶段中感知到的生活质量。
时间权衡值在疾病进展阶段有很大差异。轻度认知障碍的平均得分为0.82，轻度痴呆为0.62，中度痴呆为0.40，重度痴呆为0.25。在多元回归分析中，这些得分对年龄、性别和自我评估健康等人口统计学因素相对不敏感。
结果表明，从轻度认知障碍到痴呆进展阶段，平均时间权衡值急剧下降。由于在测量轻度认知障碍和痴呆的健康状态效用方面存在许多方法学挑战，欢迎更多评估不同方法的研究。
