title: Predictors of costs in dementia in a longitudinal perspective.
abstract: OBJECTIVE
  To analyse predictors of costs in dementia from a societal perspective in a longitudinal setting.
  
  
  METHODS
  Healthcare resource use and costs were assessed retrospectively using a questionnaire in four waves at 6-month intervals in a sample of dementia patients (N = 175). Sociodemographic data, dementia severity and comorbidity at baseline, cognitive impairment and impairment in basic and instrumental activities of daily living were also recorded. Linear mixed regression models with random intercepts for individuals were used to analyse predictors of total and sector-specific costs.
  
  
  RESULTS
  Impairment in activities of daily living significantly predicted total costs in dementia patients, with associations between basic activities of daily living and formal care costs on the one and instrumental activities of daily living and informal care costs on the other hand. Nursing home residence was associated with lower total costs than residence in the community. There was no effect of cognition on total or sector-specific costs.
  
  
  CONCLUSIONS
  Cognitive deficits in dementia are associated with costs only via their effect on the patients' capacity for activities of daily living. Transition into a nursing home may reduce total costs from a societal perspective, owing to the fact that a high amount of informal care required by severely demented patients prior to transition into a nursing home may cause higher costs than inpatient nursing care.
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Leicht
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Nina
authors.initials: N
authors.lastname: Stuhldreher
authors.forename: Cadja
authors.initials: C
authors.lastname: Bachmann
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.forename: Kathrin
authors.initials: K
authors.lastname: Heser
authors.forename: Frank
authors.initials: F
authors.lastname: Jessen
authors.forename: Mirjam
authors.initials: M
authors.lastname: Köhler
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Edelgard
authors.initials: E
authors.lastname: Mösch
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.forename: Steffi
authors.initials: S
authors.lastname: Riedel-Heller
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.forename: Jochen
authors.initials: J
authors.lastname: Werle
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
mesh_terms: D000203:Activities of Daily Living; D003072:Cognition Disorders / Q000473:pathology; D015897:Comorbidity; D003704:Dementia / Q000191:economics* / Q000473:pathology; D005858:Germany; D006295:Health Resources / Q000191:economics*; D006801:Humans; D012044:Regression Analysis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires