O5‐07‐01: BASELINE FINDINGS FROM GERAS‐US: A LONGITUDINAL COHORT STUDY OF RESOURCE USE AND COSTS OF MILD COGNITIVE IMPAIRMENT AND MILD DEMENTIA DUE TO ALZHEIMER'S DISEASE (AD) IN THE UNITED STATES

Abstract

GERAS-US aims to understand long-term clinical and economic outcomes of AD in the US. The current objective is to describe baseline findings by amyloid status and severity (mild cognitive impairment [MCI] and mild dementia [MILD]). GERAS-US is a 36-month, prospective study of patients aged 55 to 85 who enrolled from October 30, 2016, through October 9, 2017. Data collected included amyloid status, clinical assessments, and patient/study partner medical history, resource use, and health outcomes assessments. Cohorts were classified based on amyloid status (positive [+] or negative [-]) and severity (MCI: Mini-Mental State Examination [MMSE] 324, Functional Activities Questionnaire [FAQ] <6; MILD: MMSE 320, FAQ 36). Means (SD) and percentages are reported as of December 2017. Preliminary data included 87.7% of the final 1654 consented patient-study partner dyads. At interim, 259 were screen failures, 1372 had known severity (MCI=658, MILD=714), and 1147 had known amyloid findings (+=592, -=555), leaving 1144 for cross-classification (MCI+=281, MCI-=258, MILD+=311, MILD-=294). Patients’ average age was 70.4 years, and 55.1% were female. Study partners had a mean age of 58.6 years and were mostly female (65.7%), the sole caregiver (61.5%), and cohabitating with the patient (68.8%; 42.1% were spouses). Compared to MCI, MILD had poorer clinical characteristics/outcomes (Tables 1 and 2). Overall, MILD- had the highest rates of comorbidities, depression, and sleep disorders (Table 1), and the lowest patient-rated function and quality of life (Table 2). MILD+ had higher AD medication use and the lowest caregiver- and clinician-rated cognitive and functioning status (Tables 1 and 2). MILD- had the lowest rate of employment (7.8%), whereas MCI- had the highest rate of employment (23.3%) (Table 3). Total societal costs (1-month pre-baseline) were higher with increased severity (MCI: $2683, MILD: $4115) and amyloid negativity (+ $3223, - $3649) (Figure 1). Total Costs Across Cohortsa. MCI=mild cognitive impairment; MILD=mild dementia; USD=U.S. dollars; +=amyloid positive; -=amyloid negative. aTotal societal costs (1 month pre-baseline) were derived using opportunity costs. Using replacement costs resulted in lower costs including the cross-classified cohorts: MCI+ ($1661), MILD+ ($2195), MCI- ($2200), MLD- ($2303); severity cohorts: MCI ($1855), MILD ($2322), and amyloid status cohorts: + ($1942), - ($2243). Considerable clinical and economic burden was observed in early stages of AD. Differences were seen in cost and comorbidity in amyloid +/- cohorts, which underscores the need for accurate diagnosis and treatment in patients with cognitive impairment. Future GERAS-US data will aid in understanding the impact of early stage AD on patients, caregivers, and society.