Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: the DADE study

Roy W Jones; Renee Romeo; Richard Trigg; Martin Knapp; Azusa Sato; Derek King; Timothy Niecko; Loretto Lacey; DADE Investigator Group

doi:10.1016/j.jalz.2014.03.001

Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: the DADE study

Alzheimers Dement. 2015 Mar;11(3):280-90. doi: 10.1016/j.jalz.2014.03.001. Epub 2014 Jul 26.

Authors

Roy W Jones¹, Renee Romeo², Richard Trigg³, Martin Knapp⁴, Azusa Sato⁵, Derek King⁵, Timothy Niecko⁶, Loretto Lacey⁷; DADE Investigator Group

Collaborators

DADE Investigator Group:
Roy Jones, Cathey Dukes, Steve Pearson, Naji Tabet, Steve Simpson, David Wilkinson, Suvarna Wagle, Deborah Girling, Sanjana Nyatsanza, Craig Ritchie, Kunle Ashaye, John Mulinga, Jane Byrne, Sudip Sikdar, Debbie Bathgate, Rohann van der Putt, Paul Loughlin, Paul Koranteng

Affiliations

¹ RICE (The Research Institute for the Care of Older People), Royal United Hospital, Bath, UK. Electronic address: r.w.jones@bath.ac.uk.
² Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King's College London, London, UK.
³ School of Social Sciences, Nottingham Trent University, Nottingham, UK.
⁴ Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King's College London, London, UK; LSE Health and Social Care, London School of Economics and Political Science, London, UK.
⁵ LSE Health and Social Care, London School of Economics and Political Science, London, UK.
⁶ Niecko Health Economics, Naples, FL, USA.
⁷ Janssen Alzheimer Immunotherapy, Dublin, Ireland.

PMID: 25074342
DOI: 10.1016/j.jalz.2014.03.001

Abstract

Background: Most models determining how patient and caregiver characteristics and costs change with Alzheimer's disease (AD) progression focus on one aspect, for example, cognition. AD is inadequately defined by a single domain; tracking progression by focusing on a single aspect may mean other important aspects are insufficiently addressed. Dependence has been proposed as a better marker for following disease progression.

Methods: This was a cross-sectional observational study (18 UK sites). Two hundred forty-nine community or institutionalized patients, with possible/probable AD, Mini-Mental State Examination (3-26), and a knowledgeable informant participated.

Results: Significant associations noted between dependence (Dependence Scale [DS]) and clinical measures of severity (cognition, function, and behavior). Bivariate and multivariate models demonstrated significant associations between DS and service use cost, patient quality of life, and caregiver perceived burden.

Conclusion: The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research.

Keywords: Alzheimer's disease; Caregiver burden; Dependence; England; Pharmacoeconomics; Quality of life; Service use costs.

Publication types

Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Alzheimer Disease / economics*
Alzheimer Disease / psychology*
Caregivers / psychology*
Cost of Illness*
Cross-Sectional Studies
Disease Progression
England
Female
Health Care Costs
Humans
Male
Multivariate Analysis
Quality of Life*
Severity of Illness Index