RELATION BETWEEN SEVERITY OF ALZHEIMERS-DISEASE AND COSTS OF CARING

Background: Data from the Canadian Study of Health and Aging (CSHA) we re used to examine the relation between severity of Alzheimer's diseas e, as measured by the Mini-Mental State Examination (MMSE), and costs of caring. Methods: The CSHA was a community-based survey of the preva lence of dementia, including subtypes such as Alzheimer's disease, amo ng 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), mode rate (MMSE score 10-14) and severe (MMSE score below 10). Components o f care available from the CSHA were use of nursing home care, use of m edications, 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 Alzh eimer's disease. The cost per patient was estimated to be $9451 for mi ld 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 f or people with severe disease. For subjects living in the community, u npaid caregiver time and use of community services were the greatest c omponents of cost and increased with disease severity. Interpretation: The societal cost of care of Alzheimer's disease increases drasticall y with increasing disease severity. Institutionalization is responsibl e for the largest cost component.