Quality of life and disease burden in patients with MCI and dementia

Abstract

AbstractBackgroundUnderstanding of Health Related Quality of Life (HRQoL) and disease burden from Mild Cognitive Impairment (MCI) and dementia is critical to properly manage growing clinical and social burden of cognitive disorder. While each type of cognitive disorders requires different management strategy, studies separately evaluating HRQoL and disease burden of different types of dementia are sparse. Particularly, there is no study estimating disease burden from MCI. Therefore, we investigated 1) the loss of HRQoL from each of MCI, Alzheimer’s Dementia (AD), Vascular Dementia (VD), and dementia total, 2) the disease burden of each disorder in Disability Adjusted Life Year (DALY) with population representative cohort data.MethodEuro‐QoL‐5D index scores and clinical data of 6,520 elderlies are derived from Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) cohort. We built a multiple linear regression model to estimate the adjusted impact of cognitive disorder on HRQoL. For calculation of DALY, disease specific prevalence, mortality, remission rate are obtained from Korean Longitudinal Study on Health and Aging (KLOSHA) and KLOSCAD cohort. The current and future DALY from MCI, AD, VD and total dementia is calculated by standardized method according to the World Health Organization’s guideline.ResultAfter adjustment of covariates, VD causes the most substantial HRQoL loss of ‐0.309, followed by AD (‐0.143) and MCI (‐0.017). Patients with CDR ≥2 experience significantly higher loss of HRQoL (‐0.498) than patient with CDR 1 (‐0.151) or CDR <1 (‐0.096). In 2015, DALY per 100,000 attributed to AD, VD and dementia total is 417, 237, and 931 respectively. The DALY from MCI (412 per 100,000) is almost same with that of AD. The projected DALY from MCI and dementia in 2065 (9,543 per 100,000) is more than seven times bigger than 2015 (1,343 per 100,000).ConclusionCognitive disorders, especially VD, cause significant loss of HRQoL in elderlies. The disease burden from MCI as well as dementia is substantial at present and rapidly grows. From MCI stage, the early efforts should be made to prevent HRQoL loss and to manage increasing disease burden. (Supported by Korean Health Technology R&D Project, Ministry of Health and Welfare, grant number HI15C3206.)