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Butler, A,Gallagher, D,Gillespie, P,Crosby, L,Ryan, D,Lacey, L,Coen, R,O'Shea, E,Lawlor, B
2016
February
International Journal Of Geriatric Psychiatry
Frailty: a costly phenomenon in caring for elders with cognitive impairment
Published
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Optional Fields
frailty healthcare costs cognitive impairment RESIDENT SPOUSE CARERS ALL-INCLUSIVE CARE ALZHEIMERS-DISEASE OLDER PERSONS PATIENT DEPENDENCE DEMENTIA PEOPLE DISABILITY PHENOTYPE HEALTH
31
161
168
ObjectivesDementia draws on a variety of public and private resources. There is increasing pressure to define the cost components in this area to improve resource allocation and accountability. The aim of this study was to characterize frailty in a group of cognitively impaired community-dwelling elders and evaluate its relationship with cost and resource utilization.MethodsWe assessed a cross-sectional, convenient sample of 115 cognitively impaired patients of age >55years who attended the National Memory Clinic in St James' University Hospital, a Trinity College-affiliated hospital in Dublin, Ireland. Participants had a clinical diagnosis of possible Alzheimer's disease or mild cognitive impairment. Frailty was measured using the biological syndrome model. Formal health and social care costs and daily informal caregiving costs were collected and the total costs of care estimated by applying the appropriate unit cost estimate for each resource activity. Stepwise regression models were constructed to establish the factors associated with increased care costs.ResultsPatient dependence, frailty and number of co-morbid illnesses explained 43.3% of the variance in observed daily informal care costs in dementia and cognitively impaired patients. Dependence was the sole factor retained in an optimal model explaining 19% of the variance in formal health and social care costs.ConclusionFrailty retained a strong association with daily informal care costs even in the context of other known risk factors for increasing care costs. Interventions that reduce frailty as well as patient dependence on others may be associated with cost savings. Copyright (c) 2015 John Wiley & Sons, Ltd.
10.1002/gps.4306
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