Health utilities in mild cognitive impairment and dementia: a population study in Sweden.
OBJECTIVE
To collect new primary data on community-based health utilities (time trade-off values) in different stages of mild cognitive impairment and dementia from a general population sample.


METHODS
A cross-sectional study including 1,800 randomly selected members of the Swedish public aged 45-84 was performed through a postal survey; 42% response rate. The Clinical Dementia Rating scale was used for describing progressive stages of dementia in vignettes that were used in combination with time trade-off questions for valuing the perceived quality of life in these stages.


RESULTS
The time-trade off values varied considerably across the progressive disease stages. The mean score was 0.82 for mild cognitive impairment, 0.62 for mild dementia, 0.40 for moderate dementia, and 0.25 for severe dementia. In multiple regression analyses, the scores were relatively insensitive to demographic factors like age, gender and self-assessed health.


CONCLUSIONS
The results showed that the average time trade-off values declined sharply from mild cognitive impairment to progressing stages of dementia. Since there are many methodological challenges involved in measuring health state utilities in mild cognitive impairment and dementia, more research that evaluates different methods would be welcome.
Ekman
Mattias
M
Stockholm Health Economics, Stockholm, Sweden. mattias@healthecomonics.se
Berg
Jenny
J
Wimo
Anders
A
Jönsson
Linus
L
McBurney
Christopher
C
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003153:Community Health Services / Q000706:statistics & numerical data*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013548:Sweden; D014600:Utilization Review / Q000706:statistics & numerical data