Senile Dementia Of The Economic Burden Of Patients And Quality Of Life Study

To analyse the epidemiological characteristics and death tendency of elderly dementia.To study the economic burden of people with elderly dementia in nursing homes and explore the influencing factors.To assess the quality of life in people with elderly dementia and explore the influencing factors of QOL.To study the death level of the elderly dementia in Minhang District by the data from death surveillance system.Data for economic burden and the influencing factors in nursing homes were collected by cross-sectional study.Data were collected from people with elderly dementia and their caregivers using a new measure of quality of life in dementia,the QOL-AD,and using a series of instruments to measure cognition,mood,functional ability and a questionnaire to analyze the influencing factors of QOL.From 1992 to 2007,the crude mortality rate of elderly dementia increase from 8.24 per 100 000 to 16.87 per 100 000.The standardized mortality rate keeps stabile.The death age added from 78.72 to 82.37.The mortality rate of age groups above 85 for male increased from 233.21 per 100 000 to 904.04 per 100 000 and the mortality rate above 85 for female always kept high level.The elderly dementia with the prevalence rate of 21.3 per 100 takes the second place of chronic diseases in nursing homes.The mean fee per month was 1091.39 yuan.Factors such as sex.age,occupations,income,property of nursing homes, severity of disease and other chronic diseases,etc may be the main influencing factors of economic burden.The Quality of Life Alzheimer's Disease(QOL-AD) Scale demonstrated good reliability and validity.The items of "Family','Living situation'and'Life as a whole' were the high scores and the items of 'Ability to do things for fun','Memory' and 'Ability to do chores around the house' were the low scores.The mean score of QOL-AD assessed by patients(28.49±5.63) was higher than the mean score of QOL-AD assessed by caregivers(27.26±4.67).The quality of life assessed by patients was correlated with patients' depression,the quality of life assessed by caregivers was correlated with RSS, patients' depression,ADL and BPSD.The crude mortality rate of the elderly dementia increased because of population aging and improvement of death surveillance system.With the development of economy and health service,the fatality rate of elderly dementia decreased and the survival rate increased.The death level of elderly female was always high.With the increasing of life expectancy for male,the death level of elderly male increased.It was heavy economic burden for the family of elderly dementia,while health resources for elderly dementia in nursing home was deficient.Social and economic factors make a strong impact on economic burden of people with elderly dementia.With the diseases deteriorism,the cost for nursing increased.Chronic diseases not only threaten the health for the elderly,but also increased the economic burden.Caregivers who are highly burdened or depressed may rate their patient's QOL lower than patient.Patients' depression may be the important influencing factors of QOL for dementia.The presence of behavioral and psychological symptoms of dementia(BPSD) may also be an important predictor of the quality of life for dementia.To improve the quality of life in dementia,it should be done to maintain better function ability,improve mood status and increase engagement with the environment.