OBJECTIVE

To compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective.

DESIGN

Cross-sectional bottom-up cost of illness study nested within the multicenter German AgeCoDe-cohort.

SETTING

Community and nursing homes.

PARTICIPANTS

One hundred twenty-eight community-dwelling dementia patients and 48 dementia patients living in nursing homes.

INTERVENTION

None.

MEASUREMENTS

Utilization and costs of medical care and long term care, including formal and informal social and nursing care based on proxy interviews. Informal care was valued using the replacement cost method.

RESULTS

Unadjusted mean annual total costs including informal care were €29,930 ($43,997) for community-dwelling patients and €33,482 ($49,218) for patients living in nursing homes. However, multiple regression analysis controlling for age, sex, deficits in basic and instrumental activities of daily living and comorbidity showed that living in the community significantly increased total costs by €11,344 ($16,676; P < .01) compared with living in a nursing home, mainly due to higher costs of informal care (+€20,585; +$30,260; P < .001).

CONCLUSION

From the societal perspective care for dementia patients living in the community tends to cost more than care in nursing homes when functional impairment is controlled for.