Loretto Lacey PhD, Lacey Solutions, Dublin Ireland. Email:
J Nutr Health Aging. 2013 Sep;17(9):745-50. doi: 10.1007/s12603-013-0368-1.
To compare the associations between dependence and clinical measures of cognition, function and behaviour and total care cost using data from a longitudinal study in Alzheimer's disease (AD).
Longitudinal, observational study.
Community-dwelling subjects.
Male and female subjects between 50 and 85 years of age with mild to moderate AD.
None.
Subject dependence was assessed using the Dependence Scale (DS), cognition (ADAS-Cog, MMSE), function (DAD), behaviour (NPI) and resource utilization with the Resource Utilization in Dementia Questionnaire.
The repeated measures models confirmed a significant association between the DS and total care cost indicating an increase in cost with increasing dependence. A 1-unit increase in DS score was associated with a 28.60% increase in total care cost. Model 2 indicated that a one point change in MMSE, DAD and NPI is associated with 5.29%, 2.32% and 1.71% increase in total cost, respectively. Model 3 indicated that a one point change in ADAS-Cog, DAD and NPI is associated with a 1.74%, 2.42%and 1.62% increase in total cost, respectively.
Strategies which prevent deterioration in clinical measures or delay dependence should result in total cost savings. The quantitative relationships observed should assist in the economic assessment of interventions which effect cognition, function, behaviour and dependence.
利用来自阿尔茨海默病（AD）纵向研究的数据，比较依赖与认知、功能和行为的临床指标以及总护理费用之间的关系。
纵向观察性研究。
居住在社区的受试者。
年龄在 50 至 85 岁之间，轻度至中度 AD 的男性和女性受试者。
无。
使用依赖量表（DS）、认知（ADAS-Cog、MMSE）、功能（DAD）、行为（NPI）和资源利用量表（Resource Utilization in Dementia Questionnaire）评估受试者的依赖程度。
重复测量模型证实了 DS 与总护理费用之间存在显著关联，表明依赖程度增加与费用增加相关。DS 评分增加 1 个单位，总护理费用增加 28.60%。模型 2 表明，MMSE、DAD 和 NPI 每变化 1 点，总费用分别增加 5.29%、2.32%和 1.71%。模型 3 表明，ADAS-Cog、DAD 和 NPI 每变化 1 点，总费用分别增加 1.74%、2.42%和 1.62%。
预防临床指标恶化或延缓依赖的策略应导致总费用节省。观察到的定量关系应有助于对影响认知、功能、行为和依赖的干预措施进行经济评估。
