Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: The DADE study

Roy W. Jones*, Renee Romeo, Richard Trigg, Martin Knapp, Azusa Sato, Derek King, Timothy Niecko, Loretto Lacey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)


Background Most models determining how patient and caregiver characteristics and costs change with Alzheimer's disease (AD) progression focus on one aspect, for example, cognition. AD is inadequately defined by a single domain; tracking progression by focusing on a single aspect may mean other important aspects are insufficiently addressed. Dependence has been proposed as a better marker for following disease progression. Methods This was a cross-sectional observational study (18 UK sites). Two hundred forty-nine community or institutionalized patients, with possible/probable AD, Mini-Mental State Examination (3-26), and a knowledgeable informant participated. Results Significant associations noted between dependence (Dependence Scale [DS]) and clinical measures of severity (cognition, function, and behavior). Bivariate and multivariate models demonstrated significant associations between DS and service use cost, patient quality of life, and caregiver perceived burden. Conclusion The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research.

Original languageEnglish
Pages (from-to)280-290
Number of pages11
JournalAlzheimer's & Dementia
Issue number3
Publication statusPublished - 1 Mar 2015


  • Alzheimer's disease
  • Caregiver burden
  • Dependence
  • England
  • Pharmacoeconomics
  • Quality of life
  • Service use costs


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