328 Am J Geriatr Psychiatry 10:3, May-June 2002 Comparison of Healthcare Utilization and Direct Costs in Three Degenerative Dementias Daniel L. Murman, M.D., M.S., Qin Chen, M.S. Philomena M. Colucci, M.S., Christopher C. Colenda, M.D., M.P.H. Douglas J. Gelb, M.D., Ph.D., Jersey Liang, Ph.D. The authors conducted a survey of healthcare utilization in three dementia syn- dromes to determine whether type of dementia influenced utilization or resulting direct costs. Patients with Alzheimer disease (n131), dementia with parkinsonism (n85), and Huntington disease (n51) were identified from a registry and enrolled. Caregivers completed the mailed survey, and direct costs were estimated. The presence of dementia with parkinsonism resulted in significantly greater utilization of long- term care services and higher total direct costs. In all three groups, long-term care costs accounted for the majority of direct costs. Unique patterns of utilization and costs are seen in specific neurodegenerative dementias. (Am J Geriatr Psychiatry 2002; 10:328–336) Received August 14, 2000; revised January 18, 2001; accepted January 30, 2001. From the Departments of Neurology and Ophthalmology (DLM, QC, PMC) and Psychiatry (CCC), Michigan State University, E. Lansing, Michigan, and the Departments of Neurology (DJG) and Health Services Management and Policy (JL), University of Michigan, Ann Arbor, Michigan. Address correspondence to Dr. Murman, Department of Neurology and Ophthalmology, Michigan State University, B-445 Clinical Center, E. Lansing, MI 48824. e-mail: murman@pilot.msu.edu Copyright  2002 American Association for Geriatric Psychiatry T here is a growing need to understand the determi- nants of healthcare utilization and direct costs in patients suffering from dementia. Cost studies can help in planning for future utilization and in making deci- sions regarding the allocation of healthcare resources. Previous studies have demonstrated the tremendous fi- nancial impact of Alzheimer disease (AD) on society, 1–4 healthcare systems, 5–10 and individuals. 11–13 Societal costs due to AD are expected to increase rapidly in the future, based on projections that the prevalence of AD will more than double in the next 30 years. 14 Previous cost studies in AD have focused on the role of cognitive impairment in determining healthcare utilization and direct costs. 3,15 Researchers have not in- vestigated the relative impact of other core features of dementia syndromes, such as behavioral or motor symp- toms. Behavioral and motor impairments increase dis- ability and risk of institutionalization; 16–18 therefore, in- formed health policy requires an exploration of how these symptoms contribute to healthcare utilization and costs of patient care. 19 Also, it is not known whether unique dementia syndromes have different healthcare utilization patterns or resulting costs. Two recent stud- ies comparing utilization and costs in patients with probable AD and vascular dementia found different re- sults. 20,21 Specifically, one found no difference except