Comparison of informal care time and costs in different age-related dementias: A review

Abstract

Thyroid dysfunction is the second most common endocrinopathy affecting women of childbearing age. Many studies have recommended that thyroid function screening should be routinely performed in all pregnant women. The aim of the present study was to determine the prevalence of thyroid disorders during pregnancy and to evaluate efficiency of the universal screening strategy versus case-finding strategy for diagnosing thyroid dysfunctions. METHODS: Comprehensive literature search was done in PubMed and EMBASE databases till July 2012 for studies related to prevalence and screening of thyroid dysfunction. For prevalence, the primary estimate was weighed mean pooled prevalence (%) with 95% CI. For screening, the primary estimate was pooled odds ratio (OR) with 95% CI. Heterogeneity was assessed by I 2 statistics. Publication bias was assessed using Begg and Egger test. Sensitivity analysis was also performed. RESULTS: A total of 33 studies (1988-2012) for prevalence and 5 (2007-2011) for screening were found to be pertinent. Because of significant heterogeneity, a random effects model was chosen. Combined analysis of weighed pooled prevalence of 19 studies of Thyroid Auto Immunity found 9.7% (9.5-10), 21 studies of hypothyroidism found 3.7% (2.2-6.1) and 10 studies of hyperthyroidism found 2.2% (1.0-4.5), 7 studies of overt/ clinical hypothyroidism found 2% (0.8-5.1), 13 studies of subclinical hypothyroidism found 3.7% (3-4.7), 6 studies of hypothyroxinemia found 3.4% (1.2-9.8), 4 studies of overt/ clinical hyperthyroidism found 0.6% (0.3-1.4) and 5 studies of subclinical hyperthyroidism found 0.022 (1.6-2.9). For the effectiveness of universal screening pooled OR was found to be 2.87 (1.60-4.94, P-<0.001). CONCLUSIONS: Our analysis supports the hypothesis of higher prevalence of thyroid dysfunction in pregnancy especially, hypothyroidism. The universal screening strategy is found to be more effective as the case-finding strategy fails to detect the majority of pregnant women with thyroid dysfunction.

Use and costs of services and unpaid care for people with mild‐to‐moderate dementia: Baseline results from the IDEAL cohort study

“…In terms of dementia subtypes and variations in cost, and contrary to the study by Costa et al. [44], we found unpaid care costs higher for Parkinson's‐type dementia than for Alzheimer's disease participants.…”

The main cost drivers in dementia: a systematic review

“…Although most of the reviewed studies apply a societal perspective, the inclusion of different cost categories as well as cost components in direct costs vary. A lack of precise description, cost estimation and transparency in reviewed studies is evident and has been criticized earlier (Bloom et al ., ; Wimo, ; Wimo et al ., ; Costa et al ., ). A degree of consensus on the cost categories and cost components to be included in COI studies in dementia is required, especially against the background that dementia affects many different types of costs.…”

The personal cost of dementia care in Japan: A comparative analysis of residence types

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