Roy W Jones1, Renee Romeo2, Richard Trigg3, Martin Knapp4, Azusa Sato5, Derek King5, Timothy Niecko6, Loretto Lacey7. 1. RICE (The Research Institute for the Care of Older People), Royal United Hospital, Bath, UK. Electronic address: r.w.jones@bath.ac.uk. 2. Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King's College London, London, UK. 3. School of Social Sciences, Nottingham Trent University, Nottingham, UK. 4. Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King's College London, London, UK; LSE Health and Social Care, London School of Economics and Political Science, London, UK. 5. LSE Health and Social Care, London School of Economics and Political Science, London, UK. 6. Niecko Health Economics, Naples, FL, USA. 7. Janssen Alzheimer Immunotherapy, Dublin, Ireland.
Abstract
BACKGROUND: Most models determining how patient and caregiver characteristics and costs change with Alzheimer's disease (AD) progression focus on one aspect, for example, cognition. AD is inadequately defined by a single domain; tracking progression by focusing on a single aspect may mean other important aspects are insufficiently addressed. Dependence has been proposed as a better marker for following disease progression. METHODS: This was a cross-sectional observational study (18 UK sites). Two hundred forty-nine community or institutionalized patients, with possible/probable AD, Mini-Mental State Examination (3-26), and a knowledgeable informant participated. RESULTS: Significant associations noted between dependence (Dependence Scale [DS]) and clinical measures of severity (cognition, function, and behavior). Bivariate and multivariate models demonstrated significant associations between DS and service use cost, patient quality of life, and caregiver perceived burden. CONCLUSION: The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research.
BACKGROUND: Most models determining how patient and caregiver characteristics and costs change with Alzheimer's disease (AD) progression focus on one aspect, for example, cognition. AD is inadequately defined by a single domain; tracking progression by focusing on a single aspect may mean other important aspects are insufficiently addressed. Dependence has been proposed as a better marker for following disease progression. METHODS: This was a cross-sectional observational study (18 UK sites). Two hundred forty-nine community or institutionalized patients, with possible/probable AD, Mini-Mental State Examination (3-26), and a knowledgeable informant participated. RESULTS: Significant associations noted between dependence (Dependence Scale [DS]) and clinical measures of severity (cognition, function, and behavior). Bivariate and multivariate models demonstrated significant associations between DS and service use cost, patient quality of life, and caregiver perceived burden. CONCLUSION: The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research.
Authors: Noelle E Carlozzi; Carey W Sherman; Kaley Angers; Mitchell P Belanger; Amy M Austin; Kelly A Ryan Journal: Aging Ment Health Date: 2017-07-12 Impact factor: 3.658
Authors: Pavithra Chandramowlishwaran; Meng Sun; Kristin L Casey; Andrey V Romanyuk; Anastasiya V Grizel; Julia V Sopova; Aleksandr A Rubel; Carmen Nussbaum-Krammer; Ina M Vorberg; Yury O Chernoff Journal: J Biol Chem Date: 2018-01-12 Impact factor: 5.157