Dementia severity and the longitudinal costs of informal care in the Cache County population.
Dementia severity and the longitudinal costs of informal care in the Cache County population.
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DOI：
10.1016/j.jalz.2014.11.004
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发表时间：
2015-08
期刊：
影响因子：
--
通讯作者：
Tschanz JT
中科院分区：
文献类型：
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作者：
Rattinger GB;Schwartz S;Mullins CD;Corcoran C;Zuckerman IH;Sanders C;Norton MC;Fauth EB;Leoutsakos JM;Lyketsos CG;Tschanz JT
痴呆症成本对影响医疗保健政策至关重要，但存在有限的纵向信息。我们在以人群为基础的样本中检查了痴呆症的纵向非正式护理费用。来自Cache县研究的数据包括通过迷你精神状态检查（MMSE）、临床痴呆评定量表（CDR）和神经精神量表（NPI）评估的痴呆发病、持续时间和严重程度。非正式日常护理费用（COC）是根据犹他州工资中位数估算的。混合模式在MMSE和CDR的单独模式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（sd）年龄为82.3（5.9）岁]参与。总体COC以每年18%的速度增长。每增加mmse点，COC降低6%，与非常轻度痴呆相比，CDR上轻度痴呆的COC增加2倍以上，中度痴呆的COC增加5倍，重度痴呆的COC增加6倍。痴呆症严重程度越高，成本越高。针对痴呆症进展的疾病管理策略可能会抑制成本。
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 cost 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. 287 subjects [53% female, mean (sd) age was 82.3(5.9) years] participated. Overall COC increased by 18%/year. COC was 6% lower per MMSE-point increase and compared with very mild dementia, COC increased over 2-fold for mild, 5-fold for moderate and 6-fold for severe dementia on the CDR. Greater dementia severity predicted higher costs. Disease management strategies addressing dementia progression may curb costs.