i3 Innovus, Klarabergsviadukten 90 Hus D, 111 64 Stockholm, Sweden.
J Nutr Health Aging. 2010 Oct;14(8):648-54. doi: 10.1007/s12603-010-0311-7.
This study aimed to estimate the costs of formal and informal care of patients with Alzheimer's disease, to compare care costs across European countries and identify potential differences in cost patterns between countries and regions.
The ICTUS study is a prospective, naturalistic observational study conducted in specialised memory clinics in 12 European countries. In total, 1385 patients diagnosed with Alzheimer's disease were enrolled at baseline. All subjects had a reliable informant (primary caregiver) and informed consent was obtained from patients or their primary caregiver.
Resource utilization data was captured with the RUD Lite (Resource Utilization in Dementia) instrument and caregiver burden with the Zarit Burden Interview (ZBI). Patient disease severity was measured with the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), Katz´ index (PADL), Instrumental activities of daily living (IADL) scale and Neuropsychiatric inventory (NPI).
The mean annual cost of care per patient was estimated to €7,820 (95% CI: €7,194-€8,446), whereof 54% were costs of informal care, 16% direct medical costs and 30% community care costs. There were substantial differences in total resource utilization and also in the balance between formal and informal care between Northern, Western and Southern Europe. PADL scores were strongly associated with formal care costs while IADL scores correlated strongly with informal care costs.
Costs of Alzheimer's disease are high across European countries. Activities of daily living is an important determinant of care costs. Formal care service use is lower and informal care higher in Southern Europe compared to Western and Northern Europe. Differences in resource utilization patterns are important to consider in international studies of dementia care costs as well as in economic evaluations of new treatments for dementia.
本研究旨在评估阿尔茨海默病患者的正式和非正式护理成本，比较欧洲国家的护理成本，并确定国家和地区之间成本模式的潜在差异。
ICTUS 研究是一项在 12 个欧洲国家的专门记忆诊所进行的前瞻性、自然观察研究。共有 1385 名确诊为阿尔茨海默病的患者在基线时入组。所有患者都有一个可靠的知情人（主要照顾者），并获得了患者或其主要照顾者的知情同意。
资源利用数据采用 RUD Lite（痴呆症资源利用）量表和照顾者负担采用 Zarit 负担访谈（ZBI）量表进行收集。患者疾病严重程度采用简易精神状态检查（MMSE）、阿尔茨海默病评估量表-认知子量表（ADAS-cog）、Katz 指数（PADL）、工具性日常生活活动（IADL）量表和神经精神问卷（NPI）进行测量。
每位患者的年平均护理费用估计为 7820 欧元（95%置信区间：7194-8446 欧元），其中 54%为非正式护理费用，16%为直接医疗费用，30%为社区护理费用。北欧、西欧和南欧之间的总资源利用以及正式和非正式护理之间的平衡存在很大差异。PADL 评分与正式护理费用密切相关，而 IADL 评分与非正式护理费用密切相关。
欧洲各国的阿尔茨海默病护理成本都很高。日常生活活动是护理费用的重要决定因素。与北欧和西欧相比，南欧的正式护理服务使用率较低，非正式护理服务使用率较高。资源利用模式的差异对于痴呆症护理成本的国际研究以及痴呆症新疗法的经济评估都很重要。
