Lacey LA, Niecko T, Leibman C, Liu E, Grundman M

J Nutr Health Aging 2013;17:745-50.

Publication date: November 1, 2013


In patients with Alzheimer’s disease (AD), dependence has been shown to correlate with impairments in cognition, function and behaviour. In this longitudinal, observational study conducted at 39 sites in the United States and Europe between 2006 and 2009, the authors evaluated the association between dependence (as assessed by the Dependence Scale [DS]), cognitive function (Mini mental State Examination [MMSE] and Alzheimer’s Disease Assessment Scale−Cognitive Subscale [ADAS-Cog]), functional ability (Disability Assessment for Dementia [DAD]) and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]), on the one hand, and resource utilization (Resource Utilization in Dementia Questionnaire), on the other hand.

A total of 196 patients with mild to moderate AD (mean age, 75 years) participated in the study. A complete DS profile was available for 65 patients. A significant association was found between DS score and total care cost, indicating an increase in resource utilization with increasing dependence (a 1-unit increase in DS score was associated with a 28.6% increase in total care cost). Worsening of all measures of cognition, function and behaviour were also associated with quantified increases in total care cost.

As the authors note, “strategies that prevent deterioration in the clinical measures, or delay dependence, should result in total cost savings”, and the results of this study can “assist in the economic assessment of interventions which effect cognition, function and behavior in addition to dependence.

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