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Longitudinal costs of caring for people with Alzheimer's disease

Published online by Cambridge University Press:  23 September 2014

Paddy Gillespie ,
Eamon O’Shea ,
John Cullinan ,
Jacqui Buchanan ,
Joel Bobula ,
Loretto Lacey ,
Damien Gallagher ,
Aine Ni Mhaolain  and
Brian Lawlor
Paddy Gillespie*
Affiliation:
School of Business and Economics, National University of Ireland, Galway, Ireland Irish Centre for Social Gerontology, National University of Ireland, Galway, Ireland
Eamon O’Shea
Affiliation:
School of Business and Economics, National University of Ireland, Galway, Ireland Irish Centre for Social Gerontology, National University of Ireland, Galway, Ireland
John Cullinan
Affiliation:
School of Business and Economics, National University of Ireland, Galway, Ireland
Jacqui Buchanan
Affiliation:
Janssen Alzheimer Immunotherapy, Dublin, Ireland
Joel Bobula
Affiliation:
Janssen Alzheimer Immunotherapy, Dublin, Ireland
Loretto Lacey
Affiliation:
Janssen Alzheimer Immunotherapy, Dublin, Ireland
Damien Gallagher
Affiliation:
St James's Hospital, Mercer's Institute for Research on Ageing, Ireland
Aine Ni Mhaolain
Affiliation:
St James's Hospital, Mercer's Institute for Research on Ageing, Ireland
Brian Lawlor
Affiliation:
St James's Hospital, Mercer's Institute for Research on Ageing, Ireland
*
Correspondence should be addressed to: Dr. Paddy Gillespie, School of Business and Economics, NUI Galway, Galway, Ireland. Phone: +353-(0)91-495740; Fax: +353-(0)91-524130. Email: [email protected].
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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.

Keywords

Alzheimer’s diseasecostslongitudinal analysisdependencefunction
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 847 - 856
Copyright
Copyright © International Psychogeriatric Association 2014 

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