Different family caregiver- and care recipient-related factors are associated with the cost of care in the early, mild, and moderate stages of Alzheimer's disease in Finland: A 5-year ALSOVA study.

Abstract

Alzheimer's disease (AD) accounts for a significant proportion of health and social care costs. We studied family caregiver (FC), care recipient (CR), and formal care provider-related factors, which are associated with the cost of care in different stages of AD in Finland. A 5-year follow-up was conducted with 231 individuals with AD (CRs) and their FCs as a part of the ALSOVA project. The data was collected between 2002 and 06. Significant factors associated with costs were identified using a stepwise backward elimination procedure. Neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory (NPI). Across all stages of AD, each additional year of CR's education was associated with a 3.4% reduction in costs (rate ratio [RR] 0.966, 95% CI 0.940-0.993). Conversely, a one-point increase on the Neuropsychiatric Inventory was associated with a 1.8% increase in costs (RR 1.018, 95% CI 1.011-1.025). CR's neuropsychiatric symptoms (RR 1.028, 95% CI 1.010-1.047) and male FC (RR 1.756, 95% CI 1.266-2.437) were associated with increased total costs in early AD, CR's comorbidities (RR 1.138, 95% CI 1.068-1.212) and FC's burden (RR 1.032, 95% CI 1.012-1.053) in mild AD and FC being a spouse (RR 1.451, 95% CI 1.105-1.905) in moderate AD. No formal care provider-related factors were associated with total costs in any stage of AD. This study reveals several factors that may be manageable to control the costs of AD. Comprehensive prevention, evaluation, and treatment of a CR's neuropsychiatric symptoms and comorbidities should be executed early. Informal care can act as a substitute for formal care in early-stage AD, and supportive measures toward FCs should be considered. To study family caregiver, care recipient and formal care provider-related factors associated with the cost of care in different stages of Alzheimer's disease in Finland. Care recipient’s neuropsychiatric symptoms and family caregiver being a male were associated with total costs in early Alzheimer’s disease, care recipient’s comorbidities and family caregiver’s burden in mild Alzheimer’s disease and family caregiver being a spouse in moderate Alzheimer’s disease. No formal care provider-related factors were associated with total costs in any stage of Alzheimer’s disease. It is important to understand factors associated with the cost of care in different stages of Alzheimer’s disease so that costs can be properly managed and timely support can be provided for individuals with Alzheimer’s disease and their family caregivers.