Patient dependence and longitudinal changes in costs of care in Alzheimer's disease

Carolyn W. Zhu, Christopher Leibman, Trent McLaughlin, Arthur S. Zbrozek, Nikolaos Scarmeas, Marilyn Albert, Jason Brandt, Deborah Blacker, Mary Sano, Yaakov Stern

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: To examine the incremental effect of patients' dependence on others, on cost of medical and nonmedical care, and on informal caregiving hours over time. Methods: Data are obtained from 172 patients from the Predictors Study, a large, multicenter cohort of patients with probable Alzheimer disease (AD) followed annually for 4 years in 3 University-based AD centers in the USA. Enrollment required a modified Mini-Mental State Examination score ≥30. We examined the effects of patient dependence (measured by the Dependence Scale, DS) and function (measured by the Blessed Dementia Rating Scale, BDRS) on medical care cost, nonmedical care cost, and informal caregiving time using random effects regression models. Results: A one-point increase in DS score was associated with a 5.7% increase in medical cost, a 10.5% increase in nonmedical cost, and a 4.1% increase in caregiving time. A one-point increase in BDRS score was associated with a 7.6% increase in medical cost, a 3.9% increase in nonmedical cost and an 8.7% increase in caregiving time. Conclusions: Both functional impairment and patient dependence were associated with higher costs of care and caregiving time. Measures of functional impairment and patient dependence provide unique and incremental information on the overall impact of AD on patients and their caregivers.

Original languageEnglish (US)
Pages (from-to)416-423
Number of pages8
JournalDementia and Geriatric Cognitive Disorders
Volume26
Issue number5
DOIs
StatePublished - Nov 2008

Keywords

  • Alzheimer's disease
  • Costs of care, longitudinal changes
  • Patient dependence

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Psychiatry and Mental health

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