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Costs and quality of life in community-dwelling patients with Alzheimer's disease in Spain: results from the GERAS II observational study

Published online by Cambridge University Press:  19 July 2017

Javier Olazarán ,
Luis Agüera-Ortiz ,
Josep María Argimón ,
Catherine Reed ,
Antonio Ciudad ,
Paula Andrade  and
Tatiana Dilla
Javier Olazarán*
Affiliation:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Luis Agüera-Ortiz
Affiliation:
Hospital Universitario 12 de Octubre and CIBERSAM, Madrid, Spain
Josep María Argimón
Affiliation:
Divisió d'Avaluació, Servei Català de la Salut, Barcelona, Spain
Catherine Reed
Affiliation:
Eli Lilly and Company Limited, Windlesham, UK
Antonio Ciudad
Affiliation:
Lilly, S.A., Alcobendas, Madrid, Spain
Paula Andrade
Affiliation:
Lilly, S.A., Alcobendas, Madrid, Spain
Tatiana Dilla
Affiliation:
Lilly, S.A., Alcobendas, Madrid, Spain
*
*Correspondence should be addressed to: Dr Javier Olazarán, Servicio de Neurología, HGU Gregorio Marañón, Dr Esquerdo 46, 28007 MadridSpain. Phone: +34 915868339; Fax: +34 914336033. Email: [email protected].
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Abstract

Background:

Country-specific data on resource use and costs associated with Alzheimer's disease (AD) help inform governments about the increasing need for medical and financial support as the disease increases in prevalence.

Methods:

GERAS II, a prospective observational study, assessed resource use, costs, and health-related quality of life (HRQoL) among patients with AD and their caregivers in Spain. Community-dwelling patients aged ≥55 years with probable AD, and their primary caregivers, were recruited by study investigators during routine clinical practice and assessed as having mild, moderate, or moderately severe/severe (MS/S) AD dementia based on patient Mini-Mental State Examination scores. Costs of AD were calculated by applying costs to resource-use data obtained in caregiver interviews using the Resource Utilization in Dementia instrument. Total societal costs included patients’ health and social care costs and caregiver informal care costs. Baseline results are presented.

Results:

Total mean monthly societal costs/patient (2013 values) were €1514 for mild (n = 116), €2082 for moderate (n = 118), and €2818 for MS/S AD dementia (n = 146) (p value <0.001 between groups). Caregiver informal care costs comprised most of the total societal costs and differed significantly between groups (€1050, €1239, €1580, respectively; p value = 0.013), whereas patient healthcare costs did not. Across AD dementia severity groups, patient HRQoL (measured by proxy) decreased significantly (p value <0.001), caregiver subjective burden significantly increased (p value <0.001) and caregiver HRQoL was similar.

Conclusions:

Societal costs associated with AD in Spain were largely attributable to caregiver informal care costs and increased with increasing AD dementia severity.

Keywords

Alzheimer's diseaseobservational studycost analysisquality of lifeinformal careSpain
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 12 , December 2017 , pp. 2081 - 2093
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Agüera-Ortiz, L., Frank-García, A., Gil, P. and Moreno, A., 5E Study Group (2010). Clinical progression of moderate-to-severe Alzheimer's disease and caregiver burden: a 12-month multicenter prospective observational study. International Psychogeriatrics, 22, 1265–1279. doi: 10.1017/S104161021000150X.CrossRefGoogle ScholarPubMed
Argimón, J. M., Limon, E., Vila, J. and Cabezas, C. (2004). Health-related quality of life in carers of patients with dementia. Family Practice, 21, 454–457. doi: 10.1093/fampra/cmh418.Google Scholar
Arons, A. M., Krabbe, P. F., Schölzel-Dorenbos, C. J., van der Wilt, G. J. and Rikkert, M. G. (2013). Quality of life in dementia: a study on proxy bias. BioMed Central Medical Research Methodology, 13, 110.Google Scholar
Coduras, A. et al. (2010). Prospective one-year cost-of-illness study in a cohort of patients with dementia of Alzheimer's disease type in Spain: the ECO study. Journal of Alzheimer's Disease, 19, 601–615. doi: 10.3233/JAD-2010-1258.Google Scholar
Coley, N. et al. (2008). Predictive factors of attrition in a cohort of Alzheimer disease patients. The REAL.FR study. Neuroepidemiology, 31, 69–79. doi: 10.1159/000144087.Google Scholar
Cummings, J. L. et al. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.Google Scholar
Darbà, J., Kaskens, L. and Lacey, L. (2015). Relationship between global severity of patients with Alzheimer's disease and costs of care in Spain: results from the co-dependence study in Spain. European Journal of Health Economics, 16, 895–905. doi: 10.1007/s10198-014-0642-0.Google Scholar
Ferrara, M. et al. (2008). Prevalence of stress, anxiety and depression in with Alzheimer caregivers. Health and Quality of Life Outcomes, 6, 93. doi: 10.1186/1477-7525-6-93.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Galasko, D. et al. (1997). An inventory to assess activities of daily living for clinical trials in Alzheimer's disease. The Alzheimer's disease cooperative study. Alzheimer Disease and Associated Disorders, 11, S33–S39.CrossRefGoogle ScholarPubMed
Jönsson, L. et al. (2006). Patient- and proxy-reported utility in Alzheimer disease using the EuroQoL. Alzheimer Disease and Associated Disorders, 20, 49–55.Google Scholar
Kind, P. (1996). The EuroQol instrument: an index of health-related quality of life. In Spilker, B. (ed.) Quality of Life and Pharmacoeconomics in Clinical Trials (pp. 191–201). Philadelphia: Lippincott-Raven Publishers.Google Scholar
Kunz, S. (2010). Psychometric properties of the EQ-5D in a study of people with mild to moderate dementia. Quality of Life Research, 19, 425–434.CrossRefGoogle Scholar
López-Bastida, J., Serrano-Aguillar, P., Perestelo-Perez, L. and Oliva-Moreno, J. (2006). Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain. Neurology, 67, 2186–2191.Google Scholar
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7, 263–269. doi: 10.1016/j.jalz.2011.03.005.Google Scholar
OECD (2014). Dementia prevalence. In: Health at a Glance: Europe 2014. Paris: OECD Publishing. doi: https://doi.org/10.1787/health_glance_eur-2014-18-en.Google Scholar
Peña-Longobardo, L. M. and Oliva-Moreno, J. (2015). Caregiver burden in Alzheimer's disease patients in Spain. Journal of Alzheimer's Disease, 43, 1293–1302. doi: 10.3233/JAD-141374.Google Scholar
Prince, M. et al. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & Dementia, 9, 63–75. doi: 10.1016/j.jalz.2012.11.007.Google Scholar
Reed, C. et al. (2015). How useful are Eq-5d and Zbi in assessing the impact of caring for Alzheimer's disease patients?. Value in Health, 18, A760. doi: 10.1016/j.jval.2015.09.2482.Google Scholar
Rosen, W. G., Mohs, R. C. and Davis, K. L. (1984). A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 141, 1356–1364. doi: 10.1176/ajp.141. 11.1356.Google Scholar
Schölzel-Dorenbos, C. J., Draskovic, I., Vernooij-Dassen, M. J. and Olde Rikkert, M. G. (2009). Quality of life and burden of spouses of Alzheimer disease patients. Alzheimer Disease and Associated Disorders, 23, 171–177. doi: 10.1097/WAD.0b013e318190a260.Google Scholar
Serrano-Aguilar, P. G., López-Bastida, J. and Yanes-Lopez, V. (2006). Impact on health-related quality of life and perceived burden of informal caregivers of individuals with Alzheimer's disease. Neuroepidemiology, 27, 136–142. doi: 10.1159/000095760.Google Scholar
Sicras, A. et al. (2005). Prevalence, resource utilization and costs of vascular dementia compared to Alzheimer's disease in a population setting. Dementia and Geriatric Cognitive Disorders, 19, 305–315. doi: 10.1159/000084556.Google Scholar
Turró-Garriga, O. et al. for the Registry of Dementia of Girona Study Group (ReDeGi Study Group). (2015). Pharmaceutical consumption and cost in patients with dementia: a longitudinal study by the Registry of Dementias of Girona (ReDeGi) in Catalonia (Spain). Archives of Gerontology and Geriatrics 60, 448–452. doi: 10.1016/j.archger.2015.01.020.Google Scholar
Wimo, A. et al. (2013). The GERAS study: a prospective observational study of costs and resource use in community dwellers with Alzheimer's disease in three European countries – study design and baseline findings. Journal of Alzheimer's Disease, 36, 385–399. doi: 10.3233/JAD-122392.Google Scholar
Wimo, A., Jönsson, L. and Zbrozek, A. (2010). The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. Journal of Nutrition, Health & Aging, 14, 685–690. doi:10.1007/s12603-010-0316-2.Google Scholar
Wimo, A., Wetterholm, A. L., Mastey, V. and Winblad, B. (1998). Evaluation of the healthcare resource utilization and caregiver time in anti-dementia drug trials. In Wimo, A., Jönsson, B., Karlsson, G. and Winblad, B. (eds.) Health Economics of Dementia (pp. 465–499). London: John Wiley & Sons.Google Scholar
Wlodarczyk, J. H., Brodaty, H. and Hawthorne, G. (2004). The relationship between quality of life, mini-mental state examination, and the instrumental activities of daily living in patients with Alzheimer's disease. Archives of Gerontology and Geriatrics 39, 25–33. doi: 10.1016/j.archger.2003.12.004.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649–655. doi: 10.1093/geront/20.6.649.Google Scholar
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