Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Dates: 2001-2004
Funding: Novartis
Collaboraters: ETHOX, Dept of Psychiatry, University of Oxford
Information: Jane Wolstenholme

Previous studies have shown a positive relationship between disease severity and cost, usually using cognition as a proxy for disease severity and short-term cross-sectional data.

This study explored the factors affecting time to institutionalisation and estimate the relationship between the costs of care and disease progression measured by cognitive function, behavioural scores and activities of daily living.

It is based on a retrospective re-analysis of data collected as part of a prospective study of 100 patients with Alzheimer's disease or vascular dementia, followed up at 4-monthly intervals until death for a maximum of 10 years.

It was found that changes in both Mini-Mental State Examination (MMSE) and Barthel scores have independent and significant marginal effects on costs and both measures were also significantly negatively associated with the hazard of institutionalisation.


Wolstenholme J, Fenn P, Gray AM, Keene J, Hope T, Jacoby R. Estimating the Relationship Between Disease Progression and Cost of Care in Dementia, British Journal of Psychiatry 2002; 181: 36-42. Download this article