Skip to main content
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1998 Sep 8;159(5):457–465.

Relation between severity of Alzheimer's disease and costs of caring

M J Hux 1, B J O'Brien 1, M Iskedjian 1, R Goeree 1, M Gagnon 1, S Gauthier 1
PMCID: PMC1229640  PMID: 9757169

Abstract

BACKGROUND: Data from the Canadian Study of Health and Aging (CSHA) were used to examine the relation between severity of Alzheimer's disease, as measured by the Mini-Mental State Examination (MMSE), and costs of caring. METHODS: The CSHA was a community-based survey of the prevalence of dementia, including subtypes such as Alzheimer's disease, among elderly Canadians. Survey subjects with a diagnosis of possible or probable Alzheimer's disease were grouped into disease severity levels of mild (MMSE score 21-26), mild to moderate (MMSE score 15-20), moderate (MMSE score 10-14) and severe (MMSE score below 10). Components of care available from the CSHA were use of nursing home care, use of medications, use of community support services by caregivers and unpaid caregiver time. Costs were calculated from a societal perspective and are expressed in 1996 Canadian dollars. RESULTS: The annual societal cost of care per patient increased significantly with severity of Alzheimer's disease. The cost per patient was estimated to be $9451 for mild disease, $16,054 for mild to moderate disease, $25,724 for moderate disease and $36,794 for severe disease. Institutionalization was the largest component of cost, accounting for as much as 84% of the cost for people with severe disease. For subjects living in the community, unpaid caregiver time and use of community services were the greatest components of cost and increased with disease severity. INTERPRETATION: The societal cost of care of Alzheimer's disease increases drastically with increasing disease severity. Institutionalization is responsible for the largest cost component.

Full Text

The Full Text of this article is available as a PDF (196.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ernst R. L., Hay J. W., Fenn C., Tinklenberg J., Yesavage J. A. Cognitive function and the costs of Alzheimer disease. An exploratory study. Arch Neurol. 1997 Jun;54(6):687–693. doi: 10.1001/archneur.1997.00550180013006. [DOI] [PubMed] [Google Scholar]
  2. Ernst R. L., Hay J. W. The US economic and social costs of Alzheimer's disease revisited. Am J Public Health. 1994 Aug;84(8):1261–1264. doi: 10.2105/ajph.84.8.1261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Graham J. E., Rockwood K., Beattie B. L., McDowell I., Eastwood R., Gauthier S. Standardization of the diagnosis of dementia in the Canadian Study of Health and Aging. Neuroepidemiology. 1996;15(5):246–256. doi: 10.1159/000109914. [DOI] [PubMed] [Google Scholar]
  4. Gray A., Fenn P. Alzheimer's disease: the burden of the illness in England. Health Trends. 1993;25(1):31–37. [PubMed] [Google Scholar]
  5. Hay J. W., Ernst R. L. The economic costs of Alzheimer's disease. Am J Public Health. 1987 Sep;77(9):1169–1175. doi: 10.2105/ajph.77.9.1169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hu T. W., Huang L. F., Cartwright W. S. Evaluation of the costs of caring for the senile demented elderly: a pilot study. Gerontologist. 1986 Apr;26(2):158–163. doi: 10.1093/geront/26.2.158. [DOI] [PubMed] [Google Scholar]
  7. Huang L. F., Cartwright W. S., Hu T. W. The economic cost of senile dementia in the United States, 1985. Public Health Rep. 1988 Jan-Feb;103(1):3–7. [PMC free article] [PubMed] [Google Scholar]
  8. Max W., Webber P., Fox P. Alzheimer's disease. The unpaid burden of caring. J Aging Health. 1995 May;7(2):179–199. doi: 10.1177/089826439500700202. [DOI] [PubMed] [Google Scholar]
  9. McLeod P. J., Huang A. R., Tamblyn R. M., Gayton D. C. Defining inappropriate practices in prescribing for elderly people: a national consensus panel. CMAJ. 1997 Feb 1;156(3):385–391. [PMC free article] [PubMed] [Google Scholar]
  10. Ostbye T., Crosse E. Net economic costs of dementia in Canada. CMAJ. 1994 Nov 15;151(10):1457–1464. [PMC free article] [PubMed] [Google Scholar]
  11. Rice D. P., Fox P. J., Max W., Webber P. A., Lindeman D. A., Hauck W. W., Segura E. The economic burden of Alzheimer's disease care. Health Aff (Millwood) 1993 Summer;12(2):164–176. doi: 10.1377/hlthaff.12.2.164. [DOI] [PubMed] [Google Scholar]
  12. Teng E. L., Chui H. C. The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry. 1987 Aug;48(8):314–318. [PubMed] [Google Scholar]
  13. Tuokko H., Kristjansson E., Miller J. Neuropsychological detection of dementia: an overview of the neuropsychological component of the Canadian Study of Health and Aging. J Clin Exp Neuropsychol. 1995 May;17(3):352–373. doi: 10.1080/01688639508405129. [DOI] [PubMed] [Google Scholar]
  14. Welch H. G., Walsh J. S., Larson E. B. The cost of institutional care in Alzheimer's disease: nursing home and hospital use in a prospective cohort. J Am Geriatr Soc. 1992 Mar;40(3):221–224. doi: 10.1111/j.1532-5415.1992.tb02072.x. [DOI] [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES