TY - JOUR
T1 - Neuropsychiatric symptoms in patients with dementia and the longitudinal costs of informal care in the Cache County population
AU - Rattinger, Gail B.
AU - Sanders, Chelsea L.
AU - Vernon, Elizabeth
AU - Schwartz, Sarah
AU - Behrens, Stephanie
AU - Lyketsos, Constantine G.
AU - Tschanz, Jo Ann T.
N1 - Funding Information:
This study was supported by National Institute on Aging grants R01AG21136 , R01AG11380 , and P50AG005146 (Johns Hopkins ADRC). The authors are indebted to the Cache County Memory Study Investigators and staff and the participants and caregivers of the Cache County Studies.
Publisher Copyright:
© 2019 The Authors
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Alzheimer's disease
KW - Dementia
KW - Informal costs of dementia
KW - Neuropsychiatric symptoms
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U2 - 10.1016/j.trci.2019.01.002
DO - 10.1016/j.trci.2019.01.002
M3 - Article
C2 - 30911601
AN - SCOPUS:85062605041
SN - 2352-8737
VL - 5
SP - 81
EP - 88
JO - Alzheimer's and Dementia: Translational Research and Clinical Interventions
JF - Alzheimer's and Dementia: Translational Research and Clinical Interventions
ER -