i3 Innovus, Klarabergsviadukten 90 Hus D, 111 37 Stockholm, Sweden.
Curr Alzheimer Res. 2010 Jun;7(4):358-67. doi: 10.2174/156720510791162430.
Alzheimer's disease (AD) is one of the most important causes of morbidity and functional decline among the elderly and gives rise to substantial costs for society. There is today limited data on resource utilization and quality of life in AD, in particular in the severe stage of disease.
AIMS & METHODS: The objectives of this study were to estimate the relationship between costs, patient and caregiver quality of life, and disease severity. For 233 patients in Sweden and their caregivers cross-sectional data on cognitive function (MMSE), ADL ability, behavioral disturbances, formal and informal resource use and health related quality of life (HRQoL) were collected by questionnaires to caregivers and to the treating physician. Patients were stratified into the disease stages mild, moderate and severe AD based on MMSE-scores.
The mean annual total cost in 2007 USD was 23,400 in mild, 56,800 in moderate and 71,400 in severe AD. Special forms of accommodation accounted for the majority of costs. Costs were higher for patients with lower cognitive function, lower ADL ability and more behavioral disturbances, with ADL ability being the most consistent predictor of costs. There were significant differences in HRQoL between the disease stages: health utility scores were 0.64 in mild, 0.39 in moderate and 0.24 in severe AD.
The societal costs of AD are very high, especially for patients with moderate and severe AD. This implies that treatments with the ability to delay progression of the disease into more severe stages have the potential to save large costs for society.
阿尔茨海默病(AD)是导致老年人发病率和功能下降的最重要原因之一,给社会带来了巨大的成本。目前,关于 AD 的资源利用和生活质量的数据有限,特别是在疾病的严重阶段。
本研究的目的是评估成本、患者和护理人员生活质量以及疾病严重程度之间的关系。在瑞典,对 233 名患者及其护理人员进行了横断面研究,收集了认知功能(MMSE)、日常生活能力、行为障碍、正式和非正式资源利用以及健康相关生活质量(HRQoL)等数据,通过问卷收集了护理人员和治疗医生的数据。根据 MMSE 评分,患者被分为轻度、中度和重度 AD 三个疾病阶段。
2007 年,年总成本平均为轻度 AD 23400 美元,中度 AD 56800 美元,重度 AD 71400 美元。特殊形式的住宿占了大部分成本。认知功能较低、日常生活能力较低、行为障碍较多的患者成本较高,日常生活能力是成本的最一致预测因素。在疾病阶段之间存在显著的 HRQoL 差异:健康效用评分分别为轻度 0.64,中度 0.39,重度 0.24。
AD 的社会成本非常高,尤其是对中重度 AD 患者而言。这意味着,具有延缓疾病进展到更严重阶段能力的治疗方法有可能为社会节省大量成本。