Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: The DADE study

Jones, Roy; Romeo, Renée; Trigg, Richard; Knapp, Martín; Sato, Azusa; King, Derek; Niecko, Timothy; Lacey, Loretto

doi:10.1016/j.jalz.2014.03.001

Cited by 58 publications

(55 citation statements)

References 34 publications

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“…This can be done from cross-sectional data, for example, by estimating mean outcomes in each relevant disease state or by estimating statistical functions with each outcome as the dependent variable and the intermediate outcomes as explanatory variables. The dependence scale, which measures the patient's care need, has been suggested to be a valuable tool to bridge between patients' abilities to perform activities of daily living and what care is actually provided to them [48].…”

Section: Consensus On Choice Of Relevant Outcomes Is Missingmentioning

confidence: 99%

Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer's disease

Gustavsson

Green

Jones

et al. 2017

Alzheimer's & Dementia

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Available data and models for the health-economic evaluation of treatment in Alzheimer's disease (AD) have limitations causing uncertainty to decision makers. Forthcoming treatment strategies in preclinical or early AD warrant an update on the challenges associated with their economic evaluation. The perspectives of the co-authors were complemented with a targeted review of literature discussing methodological issues and data gaps in AD health-economic modelling. The methods and data available to translate treatment efficacy in early disease into long-term outcomes of relevance to policy makers and payers are limited. Current long-term large-scale data accurately representing the continuous, multifaceted, and heterogeneous disease process are missing. The potential effect of disease-modifying treatment on key long-term outcomes such as institutionalization and death is uncertain but may have great effect on cost-effectiveness. Future research should give priority to collaborative efforts to access better data on the natural progression of AD and its association with key long-term outcomes.

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Section: Consensus On Choice Of Relevant Outcomes Is Missingmentioning

confidence: 99%

Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer's disease

Gustavsson

Green

Jones

et al. 2017

Alzheimer's & Dementia

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“…Therefore, estimates evaluating AD as the 3rd most frequent cause of death in US [7], and possibly in the other developed countries with a long life expectancy are likely to be more realistic. Moreover, health care costs related to dementias (that is, mostly to AD) are estimated at the level of $259 billion in the year 2016 [6], and AD is one of the major factors affecting the quality of life at an advanced age [8]. In case of TSEs, the epidemics of "mad cow" disease led to huge losses in the European cattle industry [5].…”

Section: Introductionmentioning

confidence: 99%

Mammalian amyloidogenic proteins promote prion nucleation in yeast

Chandramowlishwaran

Sun

Casey

et al. 2018

Journal of Biological Chemistry

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Fibrous cross-β aggregates (amyloids) and their transmissible forms (prions) cause diseases in mammals (including humans) and control heritable traits in yeast. Initial nucleation of a yeast prion by transiently overproduced prion-forming protein or its (typically, QN-rich) prion domain is efficient only in the presence of another aggregated (in most cases, QN-rich) protein. Here, we demonstrate that a fusion of the prion domain of yeast protein Sup35 to some non-QN-rich mammalian proteins, associated with amyloid diseases, promotes nucleation of Sup35 prions in the absence of preexisting aggregates. In contrast, both a fusion of the Sup35 prion domain to a multimeric nonamyloidogenic protein, and an expression of a mammalian amyloidogenic protein that is not fused to the Sup35 prion domain failed to promote prion nucleation, further indicating that physical linkage of a mammalian amyloidogenic protein to the prion domain of a yeast protein is required for the nucleation of a yeast prion. Biochemical and cytological approaches confirmed the nucleation of protein aggregates in the yeast cell. Sequence alterations antagonizing or enhancing amyloidogenicity of human β amyloid (Aβ, associated with Alzheimer disease) and mouse PrP (associated with prion diseases) respectively antagonized or enhanced nucleation of a yeast prion by these proteins. The yeast-based prion nucleation assay, developed in our work, can be employed for mutational dissection of amyloidogenic proteins. We anticipate that it will aid in the identification of chemicals that influence initial amyloid nucleation and in searching for new amyloidogenic proteins in a variety of proteomes.

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“…10–14 Previous research has shown that dependence directly impacts costs of care and is associated with HRQoL and caregiver burden. 7,9,12,15 Studies have also suggested that the DS is a better candidate than the MMSE or CDR for modeling AD progression and in explaining variation in quality of life, health status and medical costs of AD patients, as well as caregiver time and associated resource use. 5,9,16 These studies suggest that the DS would be useful in models evaluating the economic impact of interventions in AD.…”

Section: Introductionmentioning

confidence: 99%

Dependence Stage and Pharmacoeconomic Outcomes in Patients With Alzheimer Disease

Michaud¹,

High²,

Charlton

et al. 2017

Alzheimer Disease &Amp; Associated Disorders

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The level of assistance patients with Alzheimer’s disease (AD) require in their care may be an important predictor of resource use, costs of care and quality of life. The Dependence Scale (DS), a measure of care-assistance required, was used to estimate costs of care and quality of life of patients with AD categorized into six dependence stages based upon the summated item scores of the DS. Data was derived from a three-year, non-interventional study of 132 patients with probable AD (ages 50 to 85) and caregiver dyads. We investigated the association between DS scores and healthcare costs, health-related quality of life (HRQoL), caregiver burden and estimated annual costs and HRQoL for six dependence stages in adjusted models. DS scores were significant predictors of healthcare costs, HRQoL, and caregiver burden. The estimated annual healthcare costs and a measure of HRQoL (EuroQoL-5D) ranged from $11,418 and 1.00 for those at very mild dependence stage to $101,715 and 0.26 for those at very severe dependence stage. DS scores classified into six dependence stages provides a useful method to estimate unique levels of care-associated costs and health utilities for pharmacoeconomic evaluations of new treatments for AD.

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Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: The DADE study

Abstract: The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research.

Cited by 58 publications

References 34 publications

Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer's disease

Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer's disease

Mammalian amyloidogenic proteins promote prion nucleation in yeast

Dependence Stage and Pharmacoeconomic Outcomes in Patients With Alzheimer Disease

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