title: Longitudinal costs of caring for people with Alzheimer's disease.
abstract: BACKGROUND
  There has been an increasing interest in the relationship between severity of disease and costs in the care of people with dementia. Much of the current evidence is based on cross-sectional data, suggesting the need to examine trends over time for this important and growing cohort of the population.
  
  
  METHODS
  This paper estimates resource use and costs of care based on longitudinal data for 72 people with dementia in Ireland. Data were collected from the Enhancing Care in Alzheimer's Disease (ECAD) study at two time points: baseline and follow-up, two years later. Patients' dependence on others was measured using the Dependence Scale (DS), while patient function was measured using the Disability Assessment for Dementia (DAD) scale. Univariate and multivariate analysis were used to explore the effects of a range of variables on formal and informal care costs.
  
  
  RESULTS
  Total costs of formal and informal care over six months rose from €9,266 (Standard Deviation (SD): 12,947) per patient at baseline to €21,266 (SD: 26,883) at follow-up, two years later. This constituted a statistically significant (p = 0.0014) increase in costs over time, driven primarily by an increase in estimated informal care costs. In the multivariate analysis, a one-point increase in the DS score, that is a one-unit increase in patient's dependence on others, was associated with a 19% increase in total costs (p = 0.0610).
  
  
  CONCLUSIONS
  Higher levels of dependence in people with Alzheimer's disease are significantly associated with increased costs of informal care as the disease progresses. Formal care services did not respond to increased dependence in people with dementia, leaving it to families to fill the caring gap, mainly through increased supervision with the progress of disease.
authors.affiliation: School of Business and Economics,National University of Ireland,Galway,Ireland.
authors.forename: Paddy
authors.initials: P
authors.lastname: Gillespie
authors.affiliation: School of Business and Economics,National University of Ireland,Galway,Ireland.
authors.forename: Eamon
authors.initials: E
authors.lastname: O'Shea
authors.affiliation: School of Business and Economics,National University of Ireland,Galway,Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Cullinan
authors.affiliation: Janssen Alzheimer Immunotherapy,Dublin,Ireland.
authors.forename: Jacqui
authors.initials: J
authors.lastname: Buchanan
authors.affiliation: Janssen Alzheimer Immunotherapy,Dublin,Ireland.
authors.forename: Joel
authors.initials: J
authors.lastname: Bobula
authors.affiliation: Janssen Alzheimer Immunotherapy,Dublin,Ireland.
authors.forename: Loretto
authors.initials: L
authors.lastname: Lacey
authors.affiliation: St James's Hospital,Mercer's Institute for Research on Ageing,Ireland.
authors.forename: Damien
authors.initials: D
authors.lastname: Gallagher
authors.affiliation: St James's Hospital,Mercer's Institute for Research on Ageing,Ireland.
authors.forename: Aine Ni
authors.initials: AN
authors.lastname: Mhaolain
authors.affiliation: St James's Hospital,Mercer's Institute for Research on Ageing,Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: Lawlor
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
keywords: function