Burden-of-illness of Dutch community-dwelling older adults with sarcopenia: Health related outcomes and costs

Abstract

ObjectiveTo explore the burden-of-illness of Dutch community-dwelling older adults with sarcopenia, in terms of disability in activities of daily living (ADL), quality of life (QoL) and costs from a societal perspective. MethodsThe Maastricht Sarcopenia Study (MaSS) was performed in adults≥65y, receiving (1) no care, (2) home care/assisted living facility, or (3) care in a residential living facility. Sarcopenia was defined according to the European Working Group on Sarcopenia algorithm. Disability in ADL was measured with the Groningen Activity Restriction Scale (GARS); QoL with the EQ-5D-5L. Subjects were questioned about their health care use and health-related costs (societal perspective). Data are presented for sarcopenic and (age and sex matched) non-sarcopenic subjects. Bootstrapping was performed to estimate 95%CI around the mean costs. Several subgroup (age, sex, living situation, comorbidities) and sensitivity analyses were performed. ResultsSarcopenic subjects (n=53) scored significantly worse on health-related outcomes compared with non-sarcopenic subjects (n=174; GARS 29±11.3 vs. 22±7.3, P<0.001, QoL 0.78±0.2 vs. 0.86±0.2, P=0.001). This difference was, except for the subscale ADL, no longer significant when compared with age and sex matched non-sarcopenic subjects (GARS 27±10.6, P=0.097, QoL 0.81±0.2, P=0.362). Mean health care costs of sarcopenic subjects (€4325, 95% CI: €3198–€5471) were significantly higher than those of non-sarcopenics (€1533, 95% CI: €1153–€1912), and higher, i.e. €1557 per three months (though not significant) compared with age and sex matched non-sarcopenics (€2768, 95% CI: €1914–€3743). Living situation (residential care) was a main driver of costs. ConclusionsCommunity-dwelling sarcopenic older adults had a higher health and economic burden than non-sarcopenic older adults. This was importantly driven by the living situation – keeping older adults independent and out of care-dependent settings may contribute to a reduction of health care costs.