Societal costs of vascular cognitive impairment in older adults.
OBJECTIVE
The construct of vascular cognitive impairment (VCI) includes many whose care is or will be costly. Nevertheless, estimates of these costs are not well described. We therefore set out to estimate the societal costs of VCI in elderly people.


METHODS
In a secondary analysis of the Canadian Study of Health and Aging, a representative cohort study, Canadian dollar costs using a societal perspective were estimated by standard methods.


RESULTS
The total annual per-patient societal costs for VCI by severity were $15 022 for those with mild disease, $14 468 for those with mild to moderate disease, $20 063 for those with moderate disease, and $34 515 for those with severe disease. The most expensive component per individual was the cost of institutional long-term care. Although severe impairment was associated with higher costs, the extent of institutionalization at all levels of severity and less drug use among those more severely impaired mitigated a severity-cost gradient.


CONCLUSIONS
The societal costs of VCI are not inconsiderable. In contrast to Alzheimer disease, there is no clear gradient relating cost to severity. Unpaid caregiver costs are an important aspect of societal costs, even in those with only mild impairment.
Rockwood
Kenneth
K
Dalhousie University, Halifax, Nova Scotia, Canada. kenneth.rockwood@dal.ca
Brown
Murray
M
Merry
Heather
H
Sketris
Ingrid
I
Fisk
John
J
D000368:Aged; D002170:Canada; D017028:Caregivers / Q000191:economics; D002561:Cerebrovascular Disorders / Q000150:complications / Q000191:economics*; D003072:Cognition Disorders / Q000191:economics* / Q000209:etiology; D015331:Cohort Studies; D017281:Cost of Illness; D016527:Drug Costs / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D012720:Severity of Illness Index; D012946:Social Welfare / Q000191:economics