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P4‐044: Differential Susceptibilities to Experimental Autoimmune Neuritis in Lewis Rat Strains
Author(s) -
Adem Abdu,
Zhu Wei,
Zhang Kejia,
Mix Eilhard,
Zhu Jie
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.08.104
Subject(s) - myelin , immunology , t cell , antigen , neuritis , myelin basic protein , cytotoxic t cell , mhc class ii , major histocompatibility complex , demyelinating disease , medicine , biology , immune system , central nervous system , multiple sclerosis , in vitro , biochemistry , endocrinology , neuroscience
Background: The Resource Use Inventory (RUI) has been used to capture resource utilization and costs in populations with Alzheimer’s disease. However, resource utilization and costs for normal, cognitively intact elderly and those with Mild Cognitive Impairment (MCI) are not well understood. Methods: Subjects are recruited from selected Alzheimer’s Disease Cooperative Study (ADCS) sites and include subjects with MCI (n 1⁄4 259) and normal elders (n 1⁄4 107). Subjects received the same annual evaluation over a three-year period. The RUI quantified subjects’ use of medical care (e.g., hospitalizations), paid care (e.g., home health aides), and time spent by unpaid caregivers helping with activities of daily living (ADL). Comparisons of utilization and costs were performed using t-tests and Wilcoxon ranksum tests. Results: Several demographic and clinical characteristics differed between normal elders and MCI subjects at baseline. MCI subjects were older (mean age 72.9 vs. 70.1, p 1⁄4 0.003), more likely to be white (93.1% vs. 69.2%, p 1⁄4 0.001) and male (53.3% vs. 39.3%, p 1⁄4 0.01). MCI subjects also had worse cognition (mean ADAS-cog 5.6 vs. 11.0, mean Mini-Mental State Examination 29.0 vs. 27.4, both p < 0.001) and function (mean ADL total score 50.7 vs. 45.7, p < 0.001). At baseline, MCI subjects were more likely to receive ADL help from unpaid caregivers (33.2% vs. 8.4%, p < 0.001), and also received more hours of unpaid care (58 vs. 10 minutes per day, p < 0.001). Medical care costs were higher for MCI subjects but differences were not statistically significant. By year 3, while utilization rates of paid and unpaid care remained low for normal elders, utilization rates increased significantly among MCI subjects for paid care (2.7% to 9.1%, p 1⁄4 0.003), unpaid care (33.2% to 46.9%, p < 0.001), and hours of unpaid care (58 to 109 minutes per day, p 1⁄4 0.001). Significant increases in medical care costs for MCI subjects ($4,819 to $11,998, p 1⁄4 0.04) but not for normal elders ($2,481 to $5,309, p 1⁄4 0.139) resulted in statistically significant differences in medical care costs in year 3. Conclusions: Resource use in paid and unpaid care are sensitive to cognitive differences in normal elders and MCI subjects. Medical care costs increased over time for both normal elders and MCI but more substantially for MCI.