title: Health utilities in mild cognitive impairment and dementia: a population study in Sweden.
abstract: 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.
authors.affiliation: Stockholm Health Economics, Stockholm, Sweden. mattias@healthecomonics.se
authors.forename: Mattias
authors.initials: M
authors.lastname: Ekman
authors.forename: Jenny
authors.initials: J
authors.lastname: Berg
authors.forename: Anders
authors.initials: A
authors.lastname: Wimo
authors.forename: Linus
authors.initials: L
authors.lastname: Jönsson
authors.forename: Christopher
authors.initials: C
authors.lastname: McBurney
mesh_terms: 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