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Clinical and economic characteristics associated with direct costs of Alzheimer's, frontotemporal and vascular dementia in Argentina

Published online by Cambridge University Press:  03 November 2010

Galeno Rojas ,
Leonardo Bartoloni ,
Carol Dillon ,
Cecilia M. Serrano ,
Monica Iturry  and
Ricardo F. Allegri
Galeno Rojas*
Affiliation:
Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCABA, Buenos Aires, Argentina
Leonardo Bartoloni
Affiliation:
Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCABA, Buenos Aires, Argentina
Carol Dillon
Affiliation:
Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCABA, Buenos Aires, Argentina
Cecilia M. Serrano
Affiliation:
Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCABA, Buenos Aires, Argentina
Monica Iturry
Affiliation:
Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCABA, Buenos Aires, Argentina
Ricardo F. Allegri
Affiliation:
Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, GCABA, Buenos Aires, Argentina
*
Correspondence should be addressed to: Dr. Galeno Rojas MD, Memory Research Center, Department of Neurology, Hospital General Abel Zubizarreta, Nueva York 3952. CP 1431. Buenos Aires, Argentina. Phone: +54 11 44333443; Fax: +54 11 44333443. Email: [email protected].
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Abstract

Background: The economic cost of dementia is high and can be predicted by cognitive and neuropsychiatric profiles. The differential costs of the various subtypes of dementia are unknown in Argentina, and this study therefore aimed to compare these costs.

Methods: Patients with a diagnosis of dementia of Alzheimer-type (DAT), frontotemporal dementia (FTD) and vascular dementia (VaD), and their primary caregivers, were evaluated between 2002 and 2008.

Results: 104 patients with dementia (DAT = 44, FTD = 34, VaD = 26) were screened and matched by age and educational level with 29 healthy subjects. Demographic variables showed no significant differences among dementia patients. The annual direct costs were US$4625 for DAT, US$4924 for FTD, and US$5112 for VaD (p > 0.05 between groups). In the post hoc analysis VaD showed higher hospitalization costs than DAT (p < 0.001). VaD exhibited lower medication costs than FTD (p < 0.001). DAT exhibited higher anti-dementia drug costs; FTD had higher psychotropic costs. In the multivariate analysis, depression, activities of daily living, and caregiver burden were correlated with direct costs (r2 = 0.76).

Conclusions: The different dementia types have different costs. Overall, costs increased with the presence of behavioral symptoms, depression and functional impairment of activities of daily living.

Keywords

Alzheimer's diseasefrontotemporal dementiavascular dementiadementiahealth economics
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 4 , May 2011 , pp. 554 - 561
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Alfabeta (2009). Pharmaceutical Online Prices and Vademecum. Available at http://www.alfabeta.net. Last accessed 4 March 2009.Google Scholar
Allegri, R. F. et al. (2007). Economic impact of dementia in developing countries: an evaluation of costs of Alzheimer-type dementia in Argentina. International Psychogeriatrics, 19, 705–718.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. 4th edn, text revision. Washington, DC: American Psychiatric Association.Google Scholar
Arizaga, R. L. et al. (2005). Deterioro cognitivo en mayores de 60 años en cañuelas (Argentina) resultado del piloto del estudio ceibo (estudio epidemiológico poblacional de demencia). Revista Neurológica Argentina, 30, 83–90.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. and Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.Google Scholar
Brun, A. et al. (1994). Clinical and neuropathological criteria for frontotemporal dementia. Journal of Neurology, Neurosurgery and Psychiatry, 57, 416–418.Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Fillit, H. and Hill, J. (2002). The costs of vascular dementia: a comparison with Alzheimer's disease. Journal of the Neurological Sciences, 203–204, 35–39.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.CrossRefGoogle ScholarPubMed
Herrmann, N et al. (2006). The contribution of neuropsychiatric symptoms to the cost of dementia care. International Journal of Geriatric Psychiatry, 21, 972–976.CrossRefGoogle Scholar
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. and Martin, R. L. (1982). A new clinical rating scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.Google Scholar
Kavanagh, S. H. and Knapp, M. (2002). Costs and cognitive disability: modelling the underlying associations. British Journal of Psychiatry, 180, 120–125.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Leon, J., Cheng, C. H. and Neumann, P. J. (1998). Alzheimer 's disease: care costs and potential savings. Health Affairs, 17, 206–216.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlin, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944.Google Scholar
Moore, M., Zhu, C. W. and Clipp, E. C. (2001). Informal costs of dementia care: estimates from the National Longitudinal Caregiver Study. Journal of Gerontology, 56B, S219–S228.Google Scholar
Pagés Larraya, F., Grasso, L. and Mari, G. (2004). Prevalencia de las demencias del tipo Alzheimer, demencias vasculares y otras demencias del DSM-IV y del ICD-10 en la República Argentina. Revista Neurológica Argentina, 29, 148–153.Google Scholar
PAMI (2010). National Institute of Social Services for Retired People and Pensioners (INSSJP–PAMI). Last updated 2010. Available at http://www.pami.org.ar. Last accessed 4 July 2010.Google Scholar
Rojas, G., Serrano, C., Dillon, C., Bartoloni, L., Iturry, M. and Allegri, R. F. (2010). Use and abuse of drugs in cognitive impairment patients. Vertex, 21, 18–23.Google Scholar
Román, G. C. et al. (1993). Vascular dementia: diagnostic criteria for research studies: report of the NINDS-AIREN International Workshop. Neurology, 43, 250–260.Google Scholar
Shah, A., Murthy, S. and Suh, G. K. (2002). Is mental health economics important in geriatric psychiatry in developing countries? International Journal of Geriatric Psychiatry, 17, 758–764.Google Scholar
Wechsler, D. (1999) Wechsler Abbreviated Scale of Intelligence (WASI). San Antonio, TX: The Psychological Corporation.Google Scholar
Wimo, A., Winblad, B. and Jönsson, L. (2007). An estimate of the total worldwide societal costs of dementia in 2005. Alzheimer's and Dementia, 3, 81–91.CrossRefGoogle ScholarPubMed
World Health Organization (2008). http://www.who.int/countries/arg/en. Last accessed on 4 July 2010.Google Scholar
Zarit, S., Orr, N. and Zarit, J. (1985). The Hidden Victims of Alzheimer's Disease: Families under Stress. New York: New York University Press.Google Scholar
Zhu, C. W. et al. (2006). Clinical features associated with costs in early AD: baseline data from the Predictors Study. Neurology, 66, 1021–1028.Google Scholar