title: Health-related resource use and costs in elderly adults with and without mild cognitive impairment.
abstract: OBJECTIVE
  To assess differences in resource use and cost between older adults with and without mild cognitive impairment (MCI) over time.
  
  
  METHODS
  Multicenter, longitudinal study.
  
  
  METHODS
  Sixty-eight Alzheimer's Disease Cooperative Study (ADCS) sites in the United States.
  
  
  METHODS
  Two hundred fifty-nine individuals diagnosed with MCI and 107 cognitively normal elderly adults followed annually for 3 years.
  
  
  METHODS
  The Resource Use Instrument (RUI) was used to capture medical and nonmedical care use. Generalized linear latent and mixed models were used to estimate differences in resource use and costs in older adults with and without MCI after controlling for clinical and demographic characteristics.
  
  
  RESULTS
  At baseline, average annual direct medical cost per person was substantially higher for participants with MCI ($6,499) than for those without ($2,969) P < .001). Informal care use was also substantially higher (33% vs 8.4%, P < .001). Results from multivariate analyses of longitudinal data show that, after controlling for participant and informant characteristics, direct medical costs were 44% higher for participants with MCI than for those without. Participants with MCI were almost five times as likely to use informal care as those without. Number of medical conditions and older age were associated with higher medical cost. Worse functional and cognitive status, older age, being married, and being female were associated with higher likelihood of informal care use. Having an adult child informant was associated with higher likelihood of using informal care.
  
  
  CONCLUSIONS
  The RUI captured differences in resource use and costs between individuals with and without MCI. Clinicians who care for individuals with MCI should address informal care needs early in the disease course.
authors: Department of Geriatrics and Palliative Medicine, Alzheimer Disease Research Center, Bronx, NY 10468, USA. carolyn.zhu@mssm.edu
authors: Carolyn W
authors: CW
authors: Zhu
authors: Mary
authors: M
authors: Sano
authors: Steven H
authors: SH
authors: Ferris
authors: Peter J
authors: PJ
authors: Whitehouse
authors: Marian B
authors: MB
authors: Patterson
authors: Paul S
authors: PS
authors: Aisen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000191:economics*; D018450:Disease Progression; D005260:Female; D017048:Health Care Costs; D006299:Health Services for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014481:United States