期刊
JOURNAL OF ALZHEIMERS DISEASE
卷 83, 期 4, 页码 1679-1690出版社
IOS PRESS
DOI: 10.3233/JAD-210713
关键词
Alzheimer's disease; dementia; facilities and services utilization; health care economics; sleep initiation and maintenance disorders
资金
- Merck Sharp & Dohme Corp., Kenilworth, NJ, USA
Insomnia in AD patients is associated with a higher comorbidity burden, increased healthcare utilization, and higher total healthcare costs. Effective management of comorbid insomnia may help reduce the incremental burden and cost implications for AD patients.
Background: Insomnia is associated with worsened clinical outcomes among Alzheimer's disease dementia (AD) patients, increased caregiver burden, and healthcare utilization. Objective: This study aimed to characterize the incremental healthcare burden of insomnia in AD using real-world data. Methods: A retrospective observational study was conducted on AD patients selected from the IBM (R) MarketScan Commercial and Medicare Supplemental Databases. AD patients with claims-based evidence of insomnia were direct matched to a non-insomnia cohort based on demographic factors. Healthcare utilization and associated costs were assessed for a 12-month follow-up period. Results: A total of 3,500 insomnia AD patients and 9,884 non-insomnia AD patients were analyzed. The insomnia cohort had a higher comorbidity burden at baseline (mean score on Charlson Comorbidity Index 2.5 versus 2.2, p < 0.001) and higher proportions of patients with baseline diagnoses for other conditions including depression: 40%, insomnia cohort versus 25%, non-insomnia (p < 0.001). AD patients with insomnia were more likely to have a claim for inpatient hospitalizations (39.8% versus 32.3%), emergency room services (56.4% versus 48.0%), and skilled-nursing services (42.6% versus 31.9%) (all p < 0.05). Mean total annual healthcare costs during the 12-month follow-up period were significantly higher among AD patients with insomnia as compared to those without. (Mean costs: $37,356 versus $27,990, p <0.001). Conclusion: AD patients with comorbid insomnia are more likely to use higher-cost healthcare services such as inpatient hospitalization, and skilled nursing, and have higher total healthcare costs. This real-world analysis provides evidence that AD disease management should consider proper treatment of comorbid insomnia due to the incremental burden and cost implications.
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