The economic impact of cognitive impairment in Parkinson's disease.

Background: We investigated to what extent cognitive impairment and dementia were related to the direct medical and nonmedical costs in Parkinson's disease. Methods: Sixty-one patients with Parkinson's disease from a population-based cohort were assessed for motor and cognitive symptoms in 1993, 1997, and 2001. Data on use of health care and social services were collected. Results: The costs of patients with dementia were 3.3 times higher (€34,980) than those of nondemented patients (€10,626) per year of survival. Institutional care was the largest cost factor, representing 67% of the costs. Cognitive functioning predicted direct costs by 29.4%. Cognitive decline was associated with increased costs, even in nondemented subjects. Conclusions: Our findings suggest that dementia has a substantial impact on direct costs in Parkinson's disease, mainly due to high costs for institutional care. In addition, there were indications that even patients with mild cognitive impairment have higher nonmedical costs. © 2011 Movement Disorder Society