COGNITIVE FUNCTION AND THE COSTS OF ALZHEIMER-DISEASE - AN EXPLORATORY-STUDY

Objective: To estimate the dollar savings in costs attainable from dru g or other treatments for Alzheimer disease (AD) that stabilize or rev erse patients' cognitive decline. Methods: Medical and other disease-r elated utilization data were collected from the caregivers of 64 patie nts diagnosed as having probable AD. The quantities of utilization wer e priced at national levels to generate measures of illness costs. Cos ts per patient were then estimated as regression functions of scores o n the Mini-Mental State Examination (MMSE), which was used as an index of patient cognitive function. Potential savings in illness costs wer e estimated by comparing predicted costs at various baseline and inter vention-level values of the patient's MMSE score. Results: The potenti al savings in illness costs attainable from treatment are small for mi ldly and very severely demented patients with AD. However, for moderat ely to severely demented home-dwelling patients having, say, an MMSE s core of 7 at baseline, prevention of a 2-point decline in the score wo uld save about $3700 annually, and a 2-point increase in an MMSE score rather than a 2-point decline would save about $7100. Conclusion: Lar ge savings in the costs of caring for moderately to severely demented home-dwelling patients with AD may be achievable from disease interven tions that have minor effects on patients' cognitive status.