Burden-of-illness of Dutch community-dwelling older adults with sarcopenia: Health related outcomes and costs

Objective: To explore the burden-of-illness of Dutch community-dwelling older adults with sarcopenia, in terms of disability in activities of daily living (ADL), quality of life (QoL) and costs from a societal perspective. Methods: The Maastricht Sarcopenia Study (MaSS) was performed in adults >= 65 y, receiving (1) no care, (2) home care/assisted living facility, or (3) care in a residential living facility. Sarcopenia was defined according to the European Working Group on Sarcopenia algorithm. Disability in ADL was measured with the Groningen Activity Restriction Scale (GARS); QoL with the EQ-5D-5L. Subjects were questioned about their health care use and health-related costs (societal perspective). Data are presented for sarcopenic and (age and sex matched) non-sarcopenic subjects. Bootstrapping was performed to estimate 95%CI around the mean costs. Several subgroup (age, sex, living situation, comorbidities) and sensitivity analyses were performed. Results: Sarcopenic subjects (n = 53) scored significantly worse on health-related outcomes compared with non-sarcopenic subjects (n = 174; GARS 29 +/- 11.3 vs. 22 +/- 7.3, P < 0.001, QoL 0.78 +/- 0.2 vs. 0.86 +/- 0.2, P = 0.001). This difference was, except for the subscale ADL, no longer significant when compared with age and sex matched non-sarcopenic subjects (GARS 27 +/- 10.6, P = 0.097, QoL 0.81 +/- 0.2, P = 0.362). Mean health care costs of sarcopenic subjects ((sic)4325, 95% CI: (sic)3198-(sic)5471) were significantly higher than those of non-sarcopenics ((sic)1533, 95% CI: (sic)1153-(sic)1912), and higher, i.e. (sic)1557 per three months (though not significant) compared with age and sex matched non-sarcopenics ((sic)2768, 95% CI: (sic)1914-(sic)3743). Living situation (residential care) was a main driver of costs. Conclusions: Community-dwelling sarcopenic older adults had a higher health and economic burden than non-sarcopenic older adults. This was importantly driven by the living situation -keeping older adults independent and out of care-dependent settings may contribute to a reduction of health care costs. (C) 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.