title: The economic impact of cognitive impairment in Parkinson's disease.
abstract: BACKGROUND
  We investigated to what extent cognitive impairment and dementia were related to the direct medical and nonmedical costs in Parkinson's disease.
  
  
  METHODS
  Sixty-one patients with Parkinson's disease from a population-based cohort were assessed for motor and cognitive symptoms in 1993, 1997, and 2001. Data on use of health care and social services were collected.
  
  
  RESULTS
  The costs of patients with dementia were 3.3 times higher (€34,980) than those of nondemented patients (€10,626) per year of survival. Institutional care was the largest cost factor, representing 67% of the costs. Cognitive functioning predicted direct costs by 29.4%. Cognitive decline was associated with increased costs, even in nondemented subjects.
  
  
  CONCLUSIONS
  Our findings suggest that dementia has a substantial impact on direct costs in Parkinson's disease, mainly due to high costs for institutional care. In addition, there were indications that even patients with mild cognitive impairment have higher nonmedical costs.
authors.affiliation: Department of Neurology, Stavanger University Hospital, Stavanger, Norway. c.vossius@hotmail.com
authors.forename: Corinna
authors.initials: C
authors.lastname: Vossius
authors.forename: Jan P
authors.initials: JP
authors.lastname: Larsen
authors.forename: Carmen
authors.initials: C
authors.lastname: Janvin
authors.forename: Dag
authors.initials: D
authors.lastname: Aarsland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000191:economics* / Q000209:etiology* / Q000523:psychology; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000191:economics* / Q000523:psychology; D012189:Retrospective Studies