Document Type
Article
Publication Date
3-13-2013
Abstract
Objectives To assess differences in resource use and cost between older adults with and without mild cognitive impairment (MCI) over time. Design Multicenter, longitudinal study. Setting Sixty-eight Alzheimer's Disease Cooperative Study (ADCS) sites in the United States. Participants Two hundred fifty-nine individuals diagnosed with MCI and 107 cognitively normal elderly adults followed annually for 3 years. Measurements The Resource Use Instrument (RUI) was used to capture medical and nonmedical care use. Generalized linear latent and mixed models were used to estimate differences in resource use and costs in older adults with and without MCI after controlling for clinical and demographic characteristics. Results At baseline, average annual direct medical cost per person was substantially higher for participants with MCI ($6,499) than for those without ($2,969) P <.001). Informal care use was also substantially higher (33% vs 8.4%, P <.001). Results from multivariate analyses of longitudinal data show that, after controlling for participant and informant characteristics, direct medical costs were 44% higher for participants with MCI than for those without. Participants with MCI were almost five times as likely to use informal care as those without. Number of medical conditions and older age were associated with higher medical cost. Worse functional and cognitive status, older age, being married, and being female were associated with higher likelihood of informal care use. Having an adult child informant was associated with higher likelihood of using informal care. Conclusion The RUI captured differences in resource use and costs between individuals with and without MCI. Clinicians who care for individuals with MCI should address informal care needs early in the disease course.
Keywords
case-control study, cost, informal care, medical care, mild cognitive impairment, resource use
Language
English
Publication Title
Journal of the American Geriatrics Society
Grant
U01AG010483
Rights
© 2013, The American Geriatrics Society. This is the peer reviewed version of the article and may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Recommended Citation
Zhu, C.W., Sano, M., Ferris, S.H., Whitehouse, P.J., Patterson, M.B. and Aisen, P.S. (2013), Health-Related Resource Use and Costs in Elderly Adults with and without Mild Cognitive Impairment. J Am Geriatr Soc, 61: 396-402. https://doi.org/10.1111/jgs.12132
Manuscript Version
Accepted Manuscript