title: Cost Related to Dementia in the Young and the Impact of Etiological Subtype on Cost.
abstract: BACKGROUND
  Young onset dementia (YOD) presents in individuals who are economically productive and socially active. While the cost related to dementia in the elderly has been widely studied, the cost related to YOD is largely unknown.
  
  
  OBJECTIVE
  To study the economic burden of community dwelling YOD in relation to late onset dementia (LOD) and cost of YOD based on etiology.
  
  
  METHODS
  In this prospective cross-sectional study of 255 patients attending a tertiary neurology center, data on economic burden, clinical features, and caregiver burden were collected using structured financial questionnaire, standard cognitive and neuropsychiatric measures, and Zarit caregiver burden scale. Cost components were grouped into those relating to direct medical costs, direct non-medical costs, and those related to indirect costs. Cost was also categorized based on etiology of YOD.
  
  
  RESULTS
  The mean age at symptom onset in the YOD and LOD cohort was 57.0 (SD 5.1) and 75.0 (SD 5.9) years, respectively. The median annual cost for patients with YOD was almost twice that of LOD (USD 15,815 versus USD 8,396). Indirect cost contributed heavily to cost related to YOD. Even when grouped by dementia etiology, YOD patients with Alzheimer's disease, frontotemporal dementia (FTD), and vascular dementia had higher cost compared to their elderly counterparts. Young onset FTD had the highest cost. 43.2% of YOD reported loss of employment due to dementia, which was significantly higher than that in LOD (2.4%).
  
  
  CONCLUSIONS
  Patients with YOD have a high economic burden. Young patients with FTD have the highest cost followed by vascular dementia and Alzheimer's disease.
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore.|Duke-NUS, Graduate Medical School, Singapore.
authors.forename: Nagaendran
authors.initials: N
authors.lastname: Kandiah
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
authors.forename: Vivian
authors.initials: V
authors.lastname: Wang
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore.
authors.forename: Xuling
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore.
authors.forename: Mei Mei
authors.initials: MM
authors.lastname: Nyu
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore.
authors.forename: Linda
authors.initials: L
authors.lastname: Lim
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore.
authors.forename: Adeline
authors.initials: A
authors.lastname: Ng
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore.
authors.forename: Shahul
authors.initials: S
authors.lastname: Hameed
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
authors.forename: Hwee Lin
authors.initials: HL
authors.lastname: Wee
mesh_terms: D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications* / Q000191:economics*; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D010468:Perceptual Disorders / Q000209:etiology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Alzheimer’s disease; economic burden; frontotemporal dementia; young-onset dementia