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Use of FDA approved medications for Alzheimer's disease in mild dementia is associated with reduced informal costs of care

Published online by Cambridge University Press:  21 March 2018

Stephanie Behrens ,
Gail B. Rattinger ,
Sarah Schwartz ,
Joshua Matyi ,
Chelsea Sanders ,
M. Scott DeBerard ,
Constantine G. Lyketsos  and
JoAnn T. Tschanz
Stephanie Behrens
Affiliation:
Department of Psychology, Utah State University, Logan, UT, USA
Gail B. Rattinger
Affiliation:
Department of Health Outcomes and Administrative Services, Binghamton University State University of New York, Binghamton, NY, USA
Sarah Schwartz
Affiliation:
Department of Psychology, Utah State University, Logan, UT, USA
Joshua Matyi
Affiliation:
Department of Psychology, Utah State University, Logan, UT, USA
Chelsea Sanders
Affiliation:
Department of Psychology, Utah State University, Logan, UT, USA
M. Scott DeBerard
Affiliation:
Department of Psychology, Utah State University, Logan, UT, USA
Constantine G. Lyketsos
Affiliation:
School of Medicine, Johns Hopkins University, Baltimore, MD, USA
JoAnn T. Tschanz*
Affiliation:
Department of Psychology, Utah State University, Logan, UT, USA
*
Correspondence should be addressed to: JoAnn T. Tschanz, 2810 Old Main Hill, Logan UT, 84322-2810, USA. Phone: +435-797-1457; Fax: +435-797-1448. Email: joann.tschanz@usu.edu.
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Abstract

Background:

The use of FDA approved medications for Alzheimer's disease [AD; FDAAMAD; (cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists)] has been associated with symptomatic benefit with a reduction in formal (paid services) and total costs of care (formal and informal costs). We examined the use of these medications and their association with informal costs in persons with dementia.

Method:

Two hundred eighty participants (53% female, 72% AD) from the longitudinal, population-based Dementia Progression Study in Cache County, Utah (USA) were followed up to ten years. Mean (SD) age at baseline was 85.6 (5.5) years. Informal costs (expressed in 2015 dollars) were calculated using the replacement cost method (hours of care multiplied by the median wage in Utah in the visit year) and adjusted for inflation using the Medical Consumer Price Index. Generalized Estimating Equations with a gamma log-link function were used to examine the longitudinal association between use of FDAAMAD and informal costs.

Results:

The daily informal cost for each participant at baseline ranged from $0 to $318.12, with the sample median of $9.40. Within the entire sample, use of FDAAMAD was not significantly associated with informal costs (expβ = 0.73, p = 0.060). In analyses restricted to participants with mild dementia at baseline (N = 222), use of FDAAMAD was associated with 32% lower costs (expβ = 0.68, p = 0.038).

Conclusions:

Use of FDAAMAD was associated with lower informal care costs in those with mild dementia only.

Keywords

informal costs of dementiadementiaAlzheimer's diseasecaregiverdementia medications
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 10: Issue Theme: Mild Cognitive Impairment , October 2018 , pp. 1499 - 1507
Copyright
Copyright © International Psychogeriatric Association 2018 

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Footnotes

Presented in preliminary form at the 21st International Association of Gerontology and Geriatrics World Congress of Gerontology and Geriatrics, San Francisco, CA.

*

Co-senior authors.

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