[Cost relation between severity of Alzheimer's disease and cognitive and functional impairment].
OBJECTIVE
This study aims to identify the relationship between costs of medical and social attention in patients with dementia of Alzheimer disease (AD) type and clinical and sociodemographic data of patients and their caregivers.


METHODS
It was an analytic observational study in a cohort of patients diagnosed with Alzheimer's disease who received ambulatory attention. Information about the use of health-related resources was collected and costs were estimated from a societal perspective. Indirect costs were calculated using a replacement cost approach. Patients and caregivers were examined with the Mini-Mental State Examination (MMSE), the Rapid Disability Rating Scale (RDRS-2), the Neuropsychiatric Inventory (NPI), the Burden Interview (BI) and the Resource Utilization in Dementia (RUD). Patients were grouped taking into account the score obtained in the MMSE.


RESULTS
A cohort of 417 patients, mean age (SD) 75.2 (6.6) years, 71% females, was studied. Disease severity levels were distributed as follows: MMSE, 26% for MMSE > 19, 66% for MMSE = 19-11, and 8% for MMSE < 11. 69% of caregivers were women, with a mean age of 57.1 (15.8) years. The cost per patient and per month was estimated to be 419.3 Euro for MMSE > 19, 641.9 Euro for MMSE = 19-11, and 1150.6 Euro for MMSE < 11.


CONCLUSIONS
The societal cost of AD increases dramatically with increasing disease severity. Caregiver burden and sex as well as the marital status of patients are associated with the cost of the disease.
López-Pousa
Secundino
S
Unidad de Valoración de la Memoria y las Demencias (UVaMiD), Hospital Santa Caterina, Girona, Spain. uvamid@ias.scs.es
Garre-Olmo
Josep
J
Turon-Estrada
Antoni
A
Hernández
Francisco
F
Expósito
Inmaculada
I
Lozano-Gallego
Manoli
M
Hernández-Ferrándiz
Marta
M
Gelada-Batlle
Esther
E
Pericot-Nierga
Imma
I
Vilalta-Franch
Joan
J
D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000191:economics* / Q000503:physiopathology; D017028:Caregivers; D003072:Cognition Disorders; D017281:Cost of Illness; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013030:Spain