Neuropsychiatric symptoms in patients with dementia and the longitudinal costs of informal care in the Cache County population

Gail B Rattinger; Chelsea L Sanders; Elizabeth Vernon; Sarah Schwartz; Stephanie Behrens; Constantine G Lyketsos; JoAnn T Tschanz

doi:10.1016/j.trci.2019.01.002

Neuropsychiatric symptoms in patients with dementia and the longitudinal costs of informal care in the Cache County population

Alzheimers Dement (N Y). 2019 Mar 11:5:81-88. doi: 10.1016/j.trci.2019.01.002. eCollection 2019.

Authors

Gail B Rattinger¹, Chelsea L Sanders², Elizabeth Vernon², Sarah Schwartz^{3

4}, Stephanie Behrens², Constantine G Lyketsos⁵, JoAnn T Tschanz^{2

4}

Affiliations

¹ School of Pharmacy and Pharmaceutical Sciences, Binghamton University State University of New York, New York, NY, USA.
² Department of Psychology, Utah State University, Logan, UT, USA.
³ Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
⁴ Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
⁵ Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.

Abstract

Introduction: Severity of dementia and neuropsychiatric symptoms contribute to increasing informal care costs. We examined which neuropsychiatric symptoms subdomains (NPS-SD) were associated with informal costs in a population-based sample.

Methods: Dementia progression and informal costs (2015 dollars) were estimated from the Cache County Dementia Progression Study. Overall NPS and specific NPS-SD were assessed with the Neuropsychiatric Inventory. Generalized Estimating Equations (GEE with gamma-distribution/log-link) modeled the relationship between NPS-SDs and informal cost trajectories.

Results: Two hundred eighty participants (52.1% female; age M = 85.67, SD = 5.60) exhibited an adjusted cost increase of 5.6% (P = .005), 6.4% (P < .001), 7.6% (P = .030), and 13% (P = .024) for every increasing Neuropsychiatric Inventory unit in psychosis-SD, affective-SD, agitation/aggression-SD, and apathy-SD, respectively. An increase in each unit of apathy was associated with a 2% annual decrease in costs (P = .040).

Discussion: We extend our prior work on informal costs and dementia severity by identifying NPS-SD associated with informal costs. Interventions targeting NPS-SD may lower informal costs.

Keywords: Alzheimer's disease; Dementia; Informal costs of dementia; Neuropsychiatric symptoms.

Abstract

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