Prevalence, resource utilization and costs of vascular dementia compared to Alzheimer's dementia in a population setting.
OBJECTIVE
To determine the prevalence of dementia and to measure the monetary impact and health resources utilization of vascular dementia (VD) compared to Alzheimer's dementia (AD) in persons aged over 64 years in a population setting.


METHODS
Retrospective, cross-sectional study. In the initial phase, information was obtained on specific clinical characteristics from the subjects with an active diagnosis of dementia. The second phase consisted of a clinical evaluation and validation of the cases. Mini-Mental State Examination was used to assess cognitive impairment. Dementia and its subtypes were determined using established diagnostic criteria. Information was obtained on the use of health care resources (direct costs) and the number of hours devoted by the primary caregiver (indirect costs) for patients with a documented diagnosis of AD or VD within the last 6 months prior to the interview. A multiple logistic regression analysis was performed to correct the model.


RESULTS
A total of 6,004 subjects were analyzed, 258 with diagnosis of dementia (overall prevalence: 4.3%). An evaluation was made of 224 patients, and gross prevalence of AD and VD was 2.4 and 1.0%, respectively. Cost per patient per semester was EUR 8,086 for AD and EUR 11,039 for VD (p = 0.016). 85.5% of the cost was attributable to primary caregiver time in AD and 84.4% in VD.


CONCLUSIONS
The prevalence of AD and VD increases with age. No sociodemographic differences were seen between AD and VD. Costs associated with health care resource and primary caregiver utilization were high, being higher in VD than in AD.
Sicras
A
A
Badalona Serveis Assistencials SL, Badalona, Barcelona, Spain.
Rejas
J
J
Arco
S
S
Flores
E
E
Ortega
G
G
Esparcia
A
A
Suárez
A
A
Gordillo
M J
MJ
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures; D006299:Health Services for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology