Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden.
J Alzheimers Dis. 2022;89(2):623-632. doi: 10.3233/JAD-215304.
The association between health-related quality of life (HRQoL) and care costs in people at risk for cognitive decline is not well understood. Studying this association could reveal the potential benefits of increasing HRQoL and reducing care costs by improving cognition.
In this exploratory data analysis we investigated the association between cognition, HRQoL utilities and costs in a well-functioning population at risk for cognitive decline.
An exploratory data analysis was conducted using longitudinal 2-year data from the FINGER study (n = 1,120). A change score analysis was applied using HRQoL utilities and total medical care costs as outcome. HRQoL utilities were derived from the Short Form Health Survey-36 (SF-36). Total care costs comprised visits to a general practitioner, medical specialist, nurse, and days at hospital. Analyses were adjusted for activities of daily living (ADL) and depressive symptoms.
Although univariable analysis showed an association between cognition and HRQoL utilities, multivariable analysis showed no association between cognition, HRQoL utilities and total care costs. A one-unit increase in ADL limitations was associated with a -0.006 (p < 0.001) decrease in HRQoL utilities and a one-unit increase in depressive symptoms was associated with a -0.004 (p < 0.001) decrease in HRQoL utilities.
The level of cognition in people at-risk for cognitive decline does not seem to be associated with HRQoL utilities. Future research should examine the level at which cognitive decline starts to affect HRQoL and care costs. Ideally, this would be done by means of cross-validation in populations with various stages of cognitive functioning and decline.
健康相关生活质量（HRQoL）与认知能力下降风险人群的护理费用之间的关系尚不清楚。研究这种关联可以揭示通过改善认知能力来提高 HRQoL 和降低护理费用的潜在益处。
在这项探索性数据分析中，我们研究了认知能力、HRQoL 效用和在认知能力下降风险人群中功能良好的人群的护理成本之间的关系。
使用 FINGER 研究的纵向 2 年数据（n=1120）进行了探索性数据分析。使用 HRQoL 效用和总医疗保健成本作为结果进行了变化分数分析。HRQoL 效用来自健康调查简表 36 项（SF-36）。总护理费用包括看全科医生、医学专家、护士和住院天数。分析调整了日常生活活动（ADL）和抑郁症状。
虽然单变量分析显示认知能力与 HRQoL 效用之间存在关联，但多变量分析显示认知能力、HRQoL 效用与总护理费用之间没有关联。ADL 限制增加一个单位与 HRQoL 效用降低 0.006（p < 0.001）有关，抑郁症状增加一个单位与 HRQoL 效用降低 0.004（p < 0.001）有关。
认知能力下降风险人群的认知水平似乎与 HRQoL 效用无关。未来的研究应该研究认知能力下降开始影响 HRQoL 和护理成本的水平。理想情况下，这可以通过在具有不同认知功能和下降阶段的人群中进行交叉验证来完成。
