Rattinger Gail B, Schwartz Sarah, Mullins C Daniel, Corcoran Chris, Zuckerman Ilene H, Sanders Chelsea, Norton Maria C, Fauth Elizabeth B, Leoutsakos Jeannie-Marie S, Lyketsos Constantine G, Tschanz JoAnn T
Pharmacy Practice Division, School of Pharmacy, Fairleigh Dickinson University, Florham Park, NJ, USA.
Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
Alzheimers Dement. 2015 Aug;11(8):946-54. doi: 10.1016/j.jalz.2014.11.004. Epub 2015 Jan 19.
Dementia costs are critical for influencing healthcare policy, but limited longitudinal information exists. We examined longitudinal informal care costs of dementia in a population-based sample.
Data from the Cache County Study included dementia onset, duration, and severity assessed by the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR), and Neuropsychiatric Inventory (NPI). Informal costs of daily care (COC) was estimated based on median Utah wages. Mixed models estimated the relationship between severity and longitudinal COC in separate models for MMSE and CDR.
Two hundred and eighty-seven subjects (53% female, mean (standard deviation) age was 82.3 (5.9) years) participated. Overall COC increased by 18% per year. COC was 6% lower per MMSE-point increase and compared with very mild dementia, COC increased over twofold for mild, fivefold for moderate, and sixfold for severe dementia on the CDR.
Greater dementia severity predicted higher costs. Disease management strategies addressing dementia progression may curb costs.
痴呆症的成本对于影响医疗保健政策至关重要,但纵向信息有限。我们在一个基于人群的样本中研究了痴呆症的纵向非正式护理成本。
来自卡什县研究的数据包括通过简易精神状态检查表(MMSE)、临床痴呆评定量表(CDR)和神经精神科问卷(NPI)评估的痴呆症发病、病程和严重程度。日常护理的非正式成本(COC)基于犹他州工资中位数进行估算。混合模型在针对MMSE和CDR的单独模型中估计了严重程度与纵向COC之间的关系。
287名受试者(53%为女性,平均(标准差)年龄为82.3(5.9)岁)参与了研究。总体COC每年增加18%。每增加一个MMSE分数,COC降低6%,与极轻度痴呆相比,轻度痴呆的COC增加了两倍多,中度痴呆增加了五倍,重度痴呆增加了六倍(基于CDR)。
痴呆症严重程度越高,成本越高。应对痴呆症进展的疾病管理策略可能会控制成本。