title: Dementia severity and the longitudinal costs of informal care in the Cache County population.
abstract: BACKGROUND
  Dementia costs are critical for influencing healthcare policy, but limited longitudinal information exists. We examined longitudinal informal care costs of dementia in a population-based sample.
  
  
  METHODS
  Data from the Cache County Study included dementia onset, duration, and severity assessed by the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR), and Neuropsychiatric Inventory (NPI). Informal costs of daily care (COC) was estimated based on median Utah wages. Mixed models estimated the relationship between severity and longitudinal COC in separate models for MMSE and CDR.
  
  
  RESULTS
  Two hundred and eighty-seven subjects (53% female, mean (standard deviation) age was 82.3 (5.9) years) participated. Overall COC increased by 18% per year. COC was 6% lower per MMSE-point increase and compared with very mild dementia, COC increased over twofold for mild, fivefold for moderate, and sixfold for severe dementia on the CDR.
  
  
  CONCLUSIONS
  Greater dementia severity predicted higher costs. Disease management strategies addressing dementia progression may curb costs.
authors.affiliation: Pharmacy Practice Division, School of Pharmacy, Fairleigh Dickinson University, Florham Park, NJ, USA.
authors.forename: Gail B
authors.initials: GB
authors.lastname: Rattinger
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schwartz
authors.affiliation: Pharmaceutical Health Services Research Department, University of Maryland Baltimore School of Pharmacy, Baltimore, MD, USA.
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Mullins
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Corcoran
authors.affiliation: Pharmaceutical Health Services Research Department, University of Maryland Baltimore School of Pharmacy, Baltimore, MD, USA.
authors.forename: Ilene H
authors.initials: IH
authors.lastname: Zuckerman
authors.affiliation: Department of Psychology, Utah State University, Logan, UT, USA.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Sanders
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Family, Consumer and Human Development, Utah State University, Logan, UT, USA.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Norton
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Family, Consumer and Human Development, Utah State University, Logan, UT, USA.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Fauth
authors.affiliation: Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Jeannie-Marie S
authors.initials: JM
authors.lastname: Leoutsakos
authors.affiliation: Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA. Electronic address: joann.tschanz@usu.edu.
authors.forename: JoAnn T
authors.initials: JT
authors.lastname: Tschanz
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics*; D018672:Community Health Planning; D003704:Dementia / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000379:methods; D005791:Patient Care / Q000191:economics* / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Alzheimer's disease costs; Costs; Dementia longitudinal costs; Longitudinal caregiving costs; Longitudinal informal dementia