Impact of Rivastigmine on Costs and on Time Spent in Caregiving for Families of Patients With Alzheimer's Disease

2003 ◽  
Vol 15 (4) ◽  
pp. 385-398 ◽  
Author(s):  
Deborah Marin ◽  
Karine Amaya ◽  
Roman Casciano ◽  
Katherine L. Puder ◽  
Julian Casciano ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Disease Progression ◽  
Caregiver Burden ◽  
Health Care Professionals ◽  
Mmse Score ◽  
Global Functioning ◽  
Early Therapy ◽  
The Impact

Background: Alzheimer's disease (AD) places a significant burden on health care systems worldwide. As new treatments are developed, their cost-effectiveness is often assessed to help health care professionals make informed decisions. In addition to the more common practice of assessing direct medical costs, indirect costs, including time spent in caregiving, should be evaluated. Methods: This study examined the potential effects of the dual cholinesterase inhibitor rivastigmine (Exelon) on caregivers of patients with AD. Results from two 26-week, placebo-controlled trials have demonstrated the clinically relevant and statistically significant efficacy of rivastigmine (6–12 mg/day) compared to placebo, on cognition, activities of daily living, and global functioning. By delaying progression of AD, significant savings in caregiver burden are anticipated, as measured by time spent caregiving and its related costs. Data collected in a prospective, observational study of AD patients and their caregivers were used to establish the relationship between disease severity (based on Mini-Mental State Examination [MMSE] score) and time spent caregiving (according to the 5-item Caregivers Activity Survery score). A significant correlation was observed between the two scores (N = 43, r = −.56, p < .0001), demonstrating that more time for supervision from caregivers is required as the disease progresses. This finding was used to estimate the reduced caregiver burden resulting from the delay in disease progression that was demonstrated with use of rivastigmine. Results: Over a 2-year period, the reduction in time spent in caregiving reached 691 hours for caregivers of patients with mild AD (MMSE score 21–30), resulting in a total savings of approximately $11,253. Treatment of patients with moderately severe AD was also evaluated. The trend was similar but the impact was less, suggesting an economic benefit to early therapy. Conclusion: Early diagnosis and a pharmacologic intervention that allows the patients to remain at home longer by delaying disease progression would have a beneficial impact on patients, caregivers, and payers, and should therefore be encouraged through initiatives designed to identify and treat patients early in the course of disease.

scholarly journals Clinical deterioration of Alzheimer’s disease patients during the Covid-19 pandemic and caregiver burden

2021 ◽  
Vol 38 (3) ◽  
pp. 255-259
Author(s):  
Nesrin HELVACI YILMAZ ◽  
Burcu POLAT ◽  
Abdulkadir ERMIS ◽  
Lutfu HANOGLU
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Sleep Disturbance ◽  
Disease Progression ◽  
Caregiver Burden ◽  
Neuropsychiatric Symptoms ◽  
Clinical Deterioration ◽  
Personal Care ◽  
The Impact

To investigate a possible deterioration of the symptoms of Alzheimer’s disease (AD) patients during a quarantine period of 60 days, and the impact on caregiver burden. This study consisted of 54 individuals (36 female, 18 male) aged 60 years and over who had been diagnosed with AD. During the quarantine period, caregivers of the patients (child, spouse, relatives) who were confined to their homes were contacted by phone and administered a survey composed of questions for neuropsychiatric symptoms and caregiver burden. Patients’ mean age was 77.18±6.96 years. The most worsening symptom was forgetfulness (35.2%) and agitation (24.1%). Incoherent speech, introversion, sleep disturbance, hallucinations, carry on with hobbies, reduced personal care, changes in appetite, and incontinence were less deteriorated. Of the caregivers, 61.1% thought that something terrible would happen to the patient, and 38.9% felt they could not find time for themselves. Drug rejection increased the burden twofold. Telemedicine methods, providing opportunities for the caregiver and the patient to walk outside, and giving medication that dissolves in the mouth or epidermal patches may be useful to prevent disease progression during the lockdown.

scholarly journals The Effectiveness of Psychoeducational and Financial Intervention to Support Caregivers of Individuals With Alzheimer’s Disease in Poland

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Magdalena Leszko
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Caregiver Burden ◽  
Health Care Professionals ◽  
Intervention Group ◽  
Spousal Caregivers ◽  
Control Group ◽  
Educational Training ◽  
Baseline Evaluation ◽  
The Government

Abstract Background and Objectives The goal of this study is to create data-driven guidelines and tools for caregivers and health care professionals that will enable caregivers to be prepared for future caregiving-related challenges and decrease their levels of stress. Research Design and Methods A total of 60 spousal caregivers of individuals with Alzheimer’s disease (AD) living in Poland were recruited for this study. The participants were assigned to two different groups. The intervention group was provided with a five-session training focused on teaching coping strategies for managing difficult behaviors and provided with a stipend for a period of 6 months (a financial aid program recently launched by the local agency). A control group was not provided with any of the interventions but asked to complete the questionnaires. The effectiveness of each intervention was assessed at a baseline and 6 months after baseline evaluation. Results Caregivers who received financial and educational training reported significantly decreased levels of depression and caregiver burden in comparison to the control group. The majority of caregivers emphasized that caregiving created financial problems and that their work has been underestimated by the government. Discussion and Implications This project addresses several issues of central importance to the success of building research foundation for the interventions. The results have the potential of generating more efficient and personalized interventions that address the needs of the caregiver as they occur, leading to increased knowledge of AD and decreased levels of depression and caregiver burden.

scholarly journals Patients With Dementia Are Easy Victims to Predators

2017 ◽  
Vol 3 ◽  
pp. 233372141773468 ◽  
Author(s):  
R. C. Hamdy ◽  
J. V. Lewis ◽  
R. Copeland ◽  
A. Depelteau ◽  
A. Kinser ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Health Care Professionals ◽  
Disease Process ◽  
Early Stages

Patients with dementia, especially Alzheimer’s disease and particularly those in early stages, are susceptible to become victims of predators: Their agnosia (see Case 1) prevents them from detecting and accurately interpreting subtle signals that otherwise would have alerted them that they are about to fall for a scam. Furthermore, their judgment is impaired very early in the disease process, often before other symptoms manifest themselves and usually before a diagnosis is made. Patients with early stages of dementia are therefore prime targets for unscrupulous predators, and it behooves caregivers and health care professionals to ensure the integrity of these patients. In this case study, we discuss how a man with mild Alzheimer’s disease was about to fall for a scam were it not for his vigilant wife. We discuss what went wrong in the patient/caregiver interaction and how the catastrophic ending could have been avoided or averted.

scholarly journals CORRELATION BETWEEN COGNITION AND FUNCTION ACROSS THE SPECTRUM OF ALZHEIMER’S DISEASE

2016 ◽  
pp. 1-7
Author(s):  
H. Liu-Seifert ◽  
E. Siemers ◽  
K. Selzler ◽  
K. Sundell ◽  
P. Aisen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Disease Progression ◽  
Mmse Score ◽  
Disease Stage ◽  
Two Phase ◽  
Identity Studies ◽  
Moderate Dementia ◽  
And Function ◽  
The Relationship

Background: Both cognitive and functional deterioration are characteristic of the clinical progression of Alzheimer’s disease (AD). Objectives: To systematically assess correlations between widely used measures of cognition and function across the spectrum of AD. Design: Spearman rank correlations were calculated for cognitive and functional measures across datasets from various AD patient populations. Setting: Post-hoc analysis from existing databases. Participants: Pooled data from placebo-treated patients with mild (MMSE score ≥20 and ≤26) and moderate (MMSE score ≥16 and ≤19) AD dementia from two Phase 3 solanezumab (EXPEDITION/2) and two semagecesatat (IDENTITY/2) studies and normal, late mild cognitive impairment (LMCI) and mild AD patients from the Alzheimer’s Disease Neuroimaging Initiative 2-Grand Opportunity (ADNI-2/GO). Intervention (if any): Placebo (EXPEDITION/2 and IDENTITY/2 subjects) Measurements: Cognitive and functional abilities were measured in all datasets. Data were collected at baseline and every three months for 18 months in EXPEDITION and IDENTITY studies; and at baseline, 6, 12, and 24 months in the ADNI dataset. Results: The relationship of cognition and function became stronger over time as AD patients progressed from preclinical to moderate dementia disease stages, with the magnitude of correlations dependent on disease stage and the complexity of functional task. The correlations were minimal in the normal control population, but became stronger with disease progression. Conclusions: This analysis found that measures of cognition and function become more strongly correlated with disease progression from preclinical to moderate dementia across multiple datasets. These findings improve the understanding of the relationship between cognitive and functional clinical measures during the course of AD progression and how cognition and function measures relate to each other in AD clinical trials.

scholarly journals Quality of Life and Caregiver Burden of Alzheimer’s Disease Among Community Dwelling Patients in Europe: Variation by Disease Severity and Progression

2021 ◽  
pp. 1-14
Author(s):  
Lutz Froelich ◽  
Albert Lladó ◽  
Rezaul K. Khandker ◽  
Montse Pedrós ◽  
Christopher M. Black ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Disease Progression ◽  
Caregiver Burden ◽  
Resource Use ◽  
Independent Predictor ◽  
Community Dwelling ◽  
Over Time

Background: Alzheimer’s disease (AD) is a significant burden on patients and caregivers. How this burden increases as disease progresses has not been well researched. Objective: To assess the association of caregiver burden and quality of life with Alzheimer’s disease severity and disease progression in community-dwelling patients in Germany, Spain, and the UK. Methods: This was a prospective observational longitudinal study of mild-to-moderate AD patients (assessed by Mini-Mental State Examination, MMSE), and their caregivers. The humanistic burden was assessed using these instruments: [Rapid Assessment of Physical Activity (RAPA), EuroQoL-5-Dimension Level (EQ-5D-5L)] and caregiver-reported [Dependence Scale (DS), EQ-5D-5L, Zarit Burden Interview (ZBI)]. Caregiver-reported healthcare resource use was assessed using the Resource Use in Dementia (RUD) and ad-hoc questions. Results: Of 616 patients recruited, 338 and 99 were followed-up at 12 and 18 months, respectively. The caregiver-reported EQ-5D-5L scores of patients’ health-related quality of life (HRQoL) showed a negative trend over time (baseline: 0.76; 18 months: 0.67) while patient-reported HRQoL remained at 0.85. DS scores tended to worsen. Disease progression was an independent predictor of HRQoL and increased dependence. Mean ZBI score increased over time reflecting an increase in caregiver burden; MMSE being an independent predictor for caregiver burden. Patient resource utilization and caregiver time for caregiving tended to increase over time. Conclusion: We found significant association between disease progression and caregiver and patient burden. Independently, both disease-specific outcomes and disease burden measures increased over time, but as disease progresses, we also found incremental burden associated with it.

Are Health Care Professionals Ready for Alzheimer's Disease: A Comparison of U.S. and Hong Kong Nurses

1994 ◽  
Vol 39 (4) ◽  
pp. 337-351 ◽  
Author(s):  
M. Christine Nagy ◽  
S. Colleen Beal ◽  
Alex Yui-Huen Kwan ◽  
Lorin A. Baumhover
Keyword(s):  
United States ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Hong Kong ◽  
Health Care Professionals ◽  
The United States ◽  
Negative Bias ◽  
Specific Training ◽  
Knowledge Test

The Alzheimer's Disease Knowledge Test (ADK) was administered to samples of practicing nurses in the United States and Hong Kong. Nurses experienced with Alzheimer's Disease patients, having specific training on AD, and reporting greater knowledge about AD were, in fact, more knowledgeable. Overall, U.S. nurses were significantly more knowledgeable, but exhibited more negative bias than Hong Kong nurses. Findings suggest that nurses in Hong Kong, as well as in the United States, need more training about Alzheimer's disease.

Reliability and Validity of the Polish Version of the Alzheimer’s Disease Knowledge Scale

2021 ◽  
pp. 1-9
Author(s):  
Magdalena Leszko ◽  
Brian D. Carpenter
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Care ◽  
General Population ◽  
Health Care Professionals ◽  
Reliability And Validity ◽  
Psychometric Evaluation ◽  
Educational Interventions ◽  
Disease Knowledge ◽  
Knowledge Scale

<b><i>Introduction:</i></b> In the context of increasing numbers of older adults and an increased prevalence of neurodegenerative diseases, the early diagnosis of dementia has become an important issue. Poland’s population is aging, and the growing number of individuals with Alzheimer’s disease (AD) may pose challenges for families and the health-care system. While creating effective psychoeducational interventions aiming at increasing caregivers’ knowledge may be beneficial, Poland lacks a standardized measurement for assessing knowledge about AD or a related form of dementia. <b><i>Methods:</i></b> The aim of our study was to translate and evaluate the Alzheimer’s Disease Knowledge Scale (ADKS) among Polish individuals. <b><i>Results:</i></b> The Polish ADKS was developed through a translation-back translation method. Psychometric evaluation was done with a sample of 942 individuals (caregivers, health-care professionals, and general population) who completed the questionnaire. <b><i>Discussion:</i></b> The results indicate that the scale produces acceptable psychometric properties and can be used to evaluate the effectiveness of educational interventions among caregivers, health-care professionals, and the general population.

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