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Longitudinal study of effects of patient characteristics on direct costs in Alzheimer disease.

Abstract

OBJECTIVES

To estimate long-term trajectories of direct cost of caring for patients with Alzheimer disease (AD) and examine the effects of patients' characteristics on cost longitudinally.

METHODS

The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed up annually for up to 7 years in three university-based AD centers in the United States. Random effects models estimated the effects of patients' clinical and sociodemographic characteristics on direct cost of care. Direct cost included cost associated with medical and nonmedical care. Clinical characteristics included cognitive status (measured by Mini-Mental State Examination), functional capacity (measured by Blessed Dementia Rating Scale [BDRS]), psychotic symptoms, behavioral problems, depressive symptoms, extrapyramidal signs, and comorbidities. The model also controlled for patients' sex, age, and living arrangements.

RESULTS

Total direct cost increased from approximately 9,239 dollars per patient per year at baseline, when all patients were at the early stages of the disease, to 19,925 dollars by year 4. After controlling for other variables, a one-point increase in the BDRS score increased total direct cost by 7.7%. One more comorbid condition increased total direct cost by 14.3%. Total direct cost was 20.8% lower for patients living at home compared with those living in an institutional setting.

CONCLUSIONS

Total direct cost of caring for patients with Alzheimer disease increased substantially over time. Much of the cost increases were explained by patients' clinical and demographic variables. Comorbidities and functional capacity were associated with higher direct cost over time.

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  • Authors+Show Affiliations

    ,

    Geriatric Research, Education, and Clinical Center, Bronx VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA. carolyn.zhu@mssm.edu

    , , , , , ,

    Source

    Neurology 67:6 2006 Sep 26 pg 998-1005

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Caregivers
    Cost of Illness
    Female
    Humans
    Longitudinal Studies
    Male
    Patient Care
    Psychiatric Status Rating Scales
    Severity of Illness Index
    Time Factors
    United States

    Pub Type(s)

    Comparative Study
    Journal Article
    Multicenter Study
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    16914696

    Citation

    Zhu, C W., et al. "Longitudinal Study of Effects of Patient Characteristics On Direct Costs in Alzheimer Disease." Neurology, vol. 67, no. 6, 2006, pp. 998-1005.
    Zhu CW, Scarmeas N, Torgan R, et al. Longitudinal study of effects of patient characteristics on direct costs in Alzheimer disease. Neurology. 2006;67(6):998-1005.
    Zhu, C. W., Scarmeas, N., Torgan, R., Albert, M., Brandt, J., Blacker, D., ... Stern, Y. (2006). Longitudinal study of effects of patient characteristics on direct costs in Alzheimer disease. Neurology, 67(6), pp. 998-1005.
    Zhu CW, et al. Longitudinal Study of Effects of Patient Characteristics On Direct Costs in Alzheimer Disease. Neurology. 2006 Sep 26;67(6):998-1005. PubMed PMID: 16914696.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Longitudinal study of effects of patient characteristics on direct costs in Alzheimer disease. AU - Zhu,C W, AU - Scarmeas,N, AU - Torgan,R, AU - Albert,M, AU - Brandt,J, AU - Blacker,D, AU - Sano,M, AU - Stern,Y, Y1 - 2006/08/16/ PY - 2006/8/18/pubmed PY - 2006/10/13/medline PY - 2006/8/18/entrez SP - 998 EP - 1005 JF - Neurology JO - Neurology VL - 67 IS - 6 N2 - OBJECTIVES: To estimate long-term trajectories of direct cost of caring for patients with Alzheimer disease (AD) and examine the effects of patients' characteristics on cost longitudinally. METHODS: The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed up annually for up to 7 years in three university-based AD centers in the United States. Random effects models estimated the effects of patients' clinical and sociodemographic characteristics on direct cost of care. Direct cost included cost associated with medical and nonmedical care. Clinical characteristics included cognitive status (measured by Mini-Mental State Examination), functional capacity (measured by Blessed Dementia Rating Scale [BDRS]), psychotic symptoms, behavioral problems, depressive symptoms, extrapyramidal signs, and comorbidities. The model also controlled for patients' sex, age, and living arrangements. RESULTS: Total direct cost increased from approximately 9,239 dollars per patient per year at baseline, when all patients were at the early stages of the disease, to 19,925 dollars by year 4. After controlling for other variables, a one-point increase in the BDRS score increased total direct cost by 7.7%. One more comorbid condition increased total direct cost by 14.3%. Total direct cost was 20.8% lower for patients living at home compared with those living in an institutional setting. CONCLUSIONS: Total direct cost of caring for patients with Alzheimer disease increased substantially over time. Much of the cost increases were explained by patients' clinical and demographic variables. Comorbidities and functional capacity were associated with higher direct cost over time. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/16914696/Longitudinal_study_of_effects_of_patient_characteristics_on_direct_costs_in_Alzheimer_disease_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=16914696 DB - PRIME DP - Unbound Medicine ER -