. 2022;89(2):623-632.

doi: 10.3233/JAD-215304.

Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline

Niels Janssen¹, Ron L Handels^{1

2}, Anders Wimo^{2

3}, Riitta Antikainen^{4

5}, Tiina Laatikainen^{6

7

8}, Hilkka Soininen^{9

10}, Timo Strandberg^{11

12}, Jaakko Tuomilehto^{6

13

14

15}, Miia Kivipelto^{6

9

16

17}, Silvia M A A Evers^{18

19}, Frans R J Verhey¹, Tiia Ngandu^{6

16}

Affiliations

¹ Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
² Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden.
³ Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
⁴ Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland.
⁵ Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
⁶ Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
⁷ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.
⁸ Joint Municipal Authority for North Karelia Social and Health Services (Siun sote), Finland.
⁹ Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
¹⁰ Department of Neurology, Kuopio University Hospital, Kuopio, Finland.
¹¹ Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Oulu, Finland.
¹² Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland.
¹³ Department of Public Health, University of Helsinki, Helsinki, Finland.
¹⁴ South Ostrobothnia Central Hospital, Seinajoki, Finland.
¹⁵ Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁶ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
¹⁷ Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK.
¹⁸ Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
¹⁹ Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Centre for Economic Evaluation Utrecht, Utrecht, The Netherlands.

PMID: 35912737
PMCID: PMC9535559
DOI: 10.3233/JAD-215304

Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline

Niels Janssen et al. J Alzheimers Dis. 2022.

. 2022;89(2):623-632.

doi: 10.3233/JAD-215304.

Authors

Affiliations

¹ Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
² Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden.
³ Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
⁴ Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland.
⁵ Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
⁶ Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
⁷ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.
⁸ Joint Municipal Authority for North Karelia Social and Health Services (Siun sote), Finland.
⁹ Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.
¹⁰ Department of Neurology, Kuopio University Hospital, Kuopio, Finland.
¹¹ Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Oulu, Finland.
¹² Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland.
¹³ Department of Public Health, University of Helsinki, Helsinki, Finland.
¹⁴ South Ostrobothnia Central Hospital, Seinajoki, Finland.
¹⁵ Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁶ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
¹⁷ Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK.
¹⁸ Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
¹⁹ Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Centre for Economic Evaluation Utrecht, Utrecht, The Netherlands.

PMID: 35912737
PMCID: PMC9535559
DOI: 10.3233/JAD-215304

Abstract

Background: The association between health-related quality of life (HRQoL) and care costs in people at risk for cognitive decline is not well understood. Studying this association could reveal the potential benefits of increasing HRQoL and reducing care costs by improving cognition.

Objective: In this exploratory data analysis we investigated the association between cognition, HRQoL utilities and costs in a well-functioning population at risk for cognitive decline.

Methods: An exploratory data analysis was conducted using longitudinal 2-year data from the FINGER study (n = 1,120). A change score analysis was applied using HRQoL utilities and total medical care costs as outcome. HRQoL utilities were derived from the Short Form Health Survey-36 (SF-36). Total care costs comprised visits to a general practitioner, medical specialist, nurse, and days at hospital. Analyses were adjusted for activities of daily living (ADL) and depressive symptoms.

Results: Although univariable analysis showed an association between cognition and HRQoL utilities, multivariable analysis showed no association between cognition, HRQoL utilities and total care costs. A one-unit increase in ADL limitations was associated with a -0.006 (p < 0.001) decrease in HRQoL utilities and a one-unit increase in depressive symptoms was associated with a -0.004 (p < 0.001) decrease in HRQoL utilities.

Conclusion: The level of cognition in people at-risk for cognitive decline does not seem to be associated with HRQoL utilities. Future research should examine the level at which cognitive decline starts to affect HRQoL and care costs. Ideally, this would be done by means of cross-validation in populations with various stages of cognitive functioning and decline.

Keywords: At-risk; HRQoL utilities; care costs; cognition,; cognitive decline; dementia,; sf-6d.

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Conflict of interest statement

Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/21-5304r2).

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Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline

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Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline

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