A cost–benefit analysis of hearing aids,including the benefits of reducing the symptoms of dementia

We carried out a CBA of hearing aids (HAs) in which we estimated the direct utility benefits, and included the indirect utility benefits working through a reduction in dementia symptoms. The benefits methodology involved using QALYs as the outcome measure and then applying the price of a QALY to convert the outcome measure into monetary terms. The price of a QALY was derived from an age-specific VSL estimate. The effects of HAs on utility were estimated from a fixed effects regression on a large national panel data set provided by NACC where we used a negative proxy for the QoL. We also used a fixed effects regression for the estimate of the indirect benefits involving HAs reducing dementia symptoms. We found that the total benefits, mainly coming from the direct benefits, were extremely large relative to the costs, with benefit–cost ratios over 30.     

The value of a year’s general education for reducing the symptoms of dementia

We present a method for estimating the benefits of years of education for reducing dementia symptoms based on the cost savings that would accrue from continuing independent living rather than relying on formal or informal carers. Our method for estimating the benefits of education involves three steps: first taking a year of education and seeing how much this lowers dementia, second using this dementia reduction and estimating how much independent living is affected and third applying the change in caregiving costs associated with the independent living change. We apply our method for estimating education benefits to a National Alzheimer’s Coordinating Center sample of 17,239 participants at 32 US Alzheimer’s disease centres over the period September 2005 and May 2015.     

阿托伐他汀钙治疗血管性痴呆的临床疗效

目的探讨阿托伐他汀钙治疗血管性痴呆的临床疗效及安全性。方法选取我院收治的血管性痴呆患者78例,随机将其分为两组,对照组患者采取常规药物治疗,治疗组患者在此基础上加用阿托伐他汀钙治疗;比较两组患者临床治疗效果。结果治疗前,两组患者简易智能状态量表(MMSE)、日常生活能力量表(ADL)及长谷川痴呆量表(HDS)评分比较,差异无统计学意义(P>0.05);治疗后,治疗组患者的MMSE评分、ADL评分、HDS评分均优于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀钙治疗血管性痴呆的临床疗效明显,可改善患者的认知功能,提高患者生活能力和生活质量。     

失智老人疗愈性庭园设计原则：目的、依据与策略

在中国进入老龄化的社会背景下,应对老年失智症的负面影响是人居环境建设中不容回避的问题。失智老人疗愈性庭园作为康复景观的类型之一,可以有效缓解病症、提高生活质量、维护患者尊严并产生节省医疗开支的经济价值。从失智老人疗愈性庭园的设计目的、设计依据和设计策略三方面进行论述,总结出脑成像对应性、身心健康支持性、行为认知适应性和庭园使用优化性4个设计策略,并且通过案例研究对设计策略进行进一步阐释。     

银杏叶提取物制剂序贯疗法对老年血管性痴呆患者记忆、认知及血流状态的影响

目的 探讨银杏叶提取物制剂序贯疗法对老年血管性痴呆患者记忆、认知及血流状态的影响.方法 选取2017年9月至2018年12月沈阳医学院附属中心医院收治的86例老年脑血管性痴呆患者作为研究对象,按治疗方法不同分为对照组(40例)与观察组(46例).两组给予常规治疗,其中包括改善微循环、抗血小板聚集等,对照组在常规治疗基础...     

Cost consequence analysis of use of a balloon expandable vascular access system and standard vascular sheath for transcatheter aortic valve implantation

Abstract

Background: Vascular complications are an important complication of transcatheter aortic valve implantation and are associated with increased morbidity and mortality as well as cost. The Solopath device is an expandable vascular access system that has previously been shown to be associated with lower rates of vascular complications. This study sought to evaluate the impact of the use of this system on vascular complications and costs in a decision model analysis.

Methods: A cost-consequence analysis was undertaken utilizing event rate data from the PARTNER trials and a published retrospective analysis of the Solopath device. The decision model estimated costs and benefits in a hypothetical cohort of patients with aortic stenosis undergoing TAVI using either a standard sheath or Solopath. The modeled analysis compared the occurrence of vascular complications and mortality at 30 days and 1 year using TreeAge Pro.

Results: The decision model demonstrated that use of the Solopath sheath resulted in 36 fewer major vascular complications, three fewer deaths at 30 days, and five fewer deaths at 1 year, resulting in a discounted cost savings of $846 CDN. Results were sensitive to decreasing rates of vascular complications with newer generation devices, however maintained modest cost-savings.

Conclusions: Reduction in vascular complications is an important part of improving care for TAVI patients. The Solopath vascular access device offers an alternative to standard sheaths with a potential reduction in complications and cost-savings.     

注射用埃索美拉唑钠血管刺激性溶血性及过敏性试验研究

目的评价注射用埃索美拉唑钠的安全性,为临床用药提供实验依据。方法通过血管刺激性试验、体外溶血性试验、全身过敏性试验,评价注射用埃索美拉唑钠的安全性。结果注射用埃索美拉唑钠无显明血管刺激性,无溶血和过敏反应。结论在本次试验条件下,注射用埃索美拉唑钠符合注射剂的安全要求。     

多奈哌齐联合盐酸美金刚、高压氧治疗血管性认知障碍患者的临床效果

目的探讨多奈哌齐联合盐酸美金刚、高压氧治疗血管性认知障碍患者的临床效果。方法选取2018年10月至2020年5月于沈阳市第一人民医院就诊的血管性认知障碍患者116例作为研究对象,按照治疗方案不同分为对照组与试验组,对照组采取多奈哌齐联合盐酸美金刚治疗,试验组在此基础上给予高压氧治疗。根据蒙特利尔认知评估量表(MoCA)对两组患者治疗前后的认知功能进行评价,比较两组患者的基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶组织抑制因子-1(TIMP-1),采用简易智力状态检查量表(MMSE)和日常生活活动能力量表(ADL)对患者的精神状态和日常生活能力进行评价。结果两组患者治疗前MoCA评分比较,差异无统计学意义(P>0.05);治疗后,两组MoCA评分升高,且试验组MoCA评分高于对照组,差异有统计学意义(P<0.05)。两组患者治疗前MMP-9和TIMP-1比较,差异无统计学意义(P>0.05);治疗后,两组患者MMP-9和TIMP-1降低,且试验组两项指标低于对照组,差异有统计学意义(P<0.05)。两组患者治疗前MMSE与ADL比较,差异无统计学意义(P>0.05);治疗后,两组患者MMSE、ADL升高,且试验组两项指标高于对照组,差异有统计学意义(P<0.05)。结论使用多奈哌齐联合美金刚、高压氧治疗血管性认知障碍,能有效改善患者的认知功能、精神状态和日常生活能力,疗效确切。     

Public perception of dementia risk in the UK: a mental models approach

Abstract

Dementia is a leading cause of death in the developed world. A number of modifiable risk factors for dementia have been identified, yet lay knowledge on dementia risk is limited. A mental models approach was used to compare lay and expert knowledge of risk in order to identify target areas for lay education. This method assumes experts and laypeople use different cognitive representations to make sense of phenomena. Semi-structured interviews were conducted with 8 experts and 15 laypeople to construct mental models of dementia risk. Interviews were transcribed verbatim and entered into NVivo qualitative data analysis software for coding. Findings indicated that laypeople had some knowledge of modifiable risk factors but in contrast to the expert mental model, laypeople poorly understood the causal links between these factors and dementia risk. Lay participants were unsure of the interaction between modifiable and non-modifiable risk factors and primarily attributed dementia risk to ‘bad luck’. It is suggested that future dementia education could benefit by building upon a general appreciation of healthy behaviour with particular focus on explaining the causal pathways to dementia risk. Additionally, it may be productive to inform laypeople it is possible to ‘change one’s luck’ by engaging in protective behaviours.     

Social and family load of Alzheimer’s disease

As the World Health Organization reports, mental illnesses have a serious impact on more than 25% of all population people worldwide at some time during their lives. Mental illnesses are universal; they affect people of any age, both women and men, the rich and the poor, no matter from which urban and rural environment they come from. Mental illnesses have an enormous economic effect on societies and on the quality of people’s life, including their families. The purpose of this study is to describe social and economic aspects of Alzheimer’s disease (AD) with respect to the early diagnosis. The authors provide an analysis of costs of treatment and care in the selected countries where the data from the available studies are recalculated into comparable quantities. Furthermore, the authors analyse aspects and possibilities of care for patients with AD in the informal (home) environment in compliance with individual phases of this disease. In the article, the method of research of available sources focusing on social and economic issues of AD is used. In order to compare costs of treatment and care of the AD patients, the Qualitative Comparative Analysis Method is exploited. The analyses have shown that the metric systems for monitoring the direct and indirect costs for the individual phases of AD are different.