The journal of nutrition, health & aging

, Volume 14, Issue 8, pp 685–690

The resource utilization in dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia

  • A. Wimo
  • L. Jonsson
  • A. Zbrozek
JNHA: Clinical Neurosciences



Informal care is a significant component of the societal resource use and costs in dementia care. Thus it is fundamental that assessments of informal care are valid. Thus the aim was to analyse the validity of time estimates with the Resource Utilization in Dementia (RUD) instrument.


Prospective observational study.


Community sample.


Fourteen married and cohabiting patient-caregiver pairs.


Comparisons of estimates of caregiver time by recall with the RUD instrument, by diaries and by direct observation, with calculation of agreement statistics for recall vs. diary and recall vs. direct observation to assess accuracy of the time estimates derived from recall.


The patients and their caregivers participated in 47 diaries and 30 observation sessions. The agreement between diaries and recall estimates was high for personal ADL (intra-class correlation (ICC) 0.93), supervision (ICC 0.87) and total time (ICC 0.91) and lower but acceptable for instrumental ADL (ICC 0.75). Regarding observation vs recall estimates, the corresponding figures were for personal ADL (ICC 0.81), for instrumental ADL (ICC 0.74), for supervision (ICC 0.78) and for total time (ICC 0.80).


The RUD instrument appears to accurately estimate the amount of informal care provided by caregivers to dementia patients

Key words

RUD resource utilization in dementia Alzheimer's disease economics validation 


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  1. 1.
    Wimo A, Jonsson L, Winblad B. An Estimate of the Worldwide Prevalence and Direct Costs of Dementia in 2003. Dement Geriatr Cogn Disord. 2006 Jan 9;21(3):175–181.CrossRefPubMedGoogle Scholar
  2. 2.
    Jonsson B, Jonsson L, Wimo A. Cost of dementia. In: May M, Sartorius N, editors. Dementia WPA Series Evidence and experience in Psychiatry. London: John Wiley & Son; 2000. p. 335–363.Google Scholar
  3. 3.
    Wimo A, Wetterholm AL, Mastey V, Winblad B. Evaluation of the resource utilization and caregiver time in Anti-dementia drug trials — a quantitative battery. In: Wimo A, Jonsson B, Karlsson G, Winblad B, editors. The Health Economis of dementia. London: John Wiley & Sons; 1998. p. 465–499.Google Scholar
  4. 4.
    Clipp EC, Moore MJ. Caregiver time use: an outcome measure in clinical trial research on Alzheimer's disease. Clin Pharmacol Ther. 1995 Aug;58(2):228–236.CrossRefPubMedGoogle Scholar
  5. 5.
    Davis KL, Marin DB, Kane R, Patrick D, Peskind ER, Raskind MA, et al. The Caregiver Activity Survey (CAS): development and validation of a new measure for caregivers of persons with Alzheimer's disease. Int J Geriatr Psychiatry. 1997;12(10):978–988.CrossRefPubMedGoogle Scholar
  6. 6.
    Feldman H, Gauthier S, Hecker J, Vellas B, Hux M, Xu Y, et al. Economic evaluation of donepezil in moderate to severe Alzheimer disease. Neurology. 2004 Aug 24;63(4):644–650.PubMedGoogle Scholar
  7. 7.
    Beecham J, Knapp M. Costing psychiatric interventions. In: Thornicroft G, editor. Measuring mental health needs. London: Gaskell; 2001. p. 200–224.Google Scholar
  8. 8.
    Wimo A, Winblad B, Engedal K, Soininen H, Verhey F, Waldemar G, et al. An economic evaluation of donepezil in mild to moderate Alzheimer's disease: results of a 1-year, double-blind, randomized trial. Dement Geriatr Cogn Disord. 2003;15(1):44–54.CrossRefPubMedGoogle Scholar
  9. 9.
    Wimo A, Winblad B, Stöffler A, Wirth Y, Möbius HJ. Resource Utilization and Cost Analysis of Memantine in Patients with Moderate to Severe Alzheimer's Disease. Pharmacoeconomics. 2003;21(5):327–340.CrossRefPubMedGoogle Scholar
  10. 10.
    Coduras A, Rabasa I, Frank A, Bermejo-Pareja F, Lopez-Pousa S, Lopez-Arrieta JM, et al. Prospective one-year cost-of-illness study in a cohort of patients with dementia of Alzheimer's disease type in Spain: the ECO study. J Alzheimers Dis. Jan; 19(2):601–615.Google Scholar
  11. 11.
    Suh GH, Knapp M, Kang CJ. The economic costs of dementia in Korea, 2002. Int J Geriatr Psychiatry. 2006 Aug;21(8):722–728.CrossRefPubMedGoogle Scholar
  12. 12.
    Bostrom F, Jonsson L, Minthon L, Londos E. Patients with Lewy body dementia use more resources than those with Alzheimer's disease. Int J Geriatr Psychiatry. 2007 Aug;22(8):713–719.CrossRefPubMedGoogle Scholar
  13. 13.
    Neubauer S, Holle R, Menn P, Grossfeld-Schmitz M, Graesel E. Measurement of informal care time in a study of patients with dementia. Int Psychogeriatr. 2008 Dec;20(6):1160–1176.CrossRefPubMedGoogle Scholar
  14. 14.
    Mesterton J, Wimo A, By A, Langworth S, Winblad B, Jonsson L. Cross Sectional Observational Study on the Societal Costs of Alzheimer's Disease. Curr Alzheimer Res. 2009 Nov 26.Google Scholar
  15. 15.
    Wimo A, Winblad B. Resource utilisation in dementia: RUD Lite. Brain Aging. 2003;3:48–59.Google Scholar
  16. 16.
    Wimo A, Nordberg G. Validity and reliability of assessments of time Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr. 2006 Jun 12;44:71–81.CrossRefPubMedGoogle Scholar
  17. 17.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198.CrossRefPubMedGoogle Scholar
  18. 18.
    Katz S, Ford AB, Moskowitz RB, Jackson BA, Jaffe MW. A standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919.PubMedGoogle Scholar
  19. 19.
    Lagergren M, Fratiglioni L, Hallberg IR, Berglund J, Elmstahl S, Hagberg B, et al. A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC). Aging Clin Exp Res. 2004 Apr;16(2):158–168.PubMedGoogle Scholar
  20. 20.
    van den Berg B, Spauwen P. Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving. Health Econ. 2006 May;15(5):447–460.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer Verlag France 2010

Authors and Affiliations

  • A. Wimo
    • 1
    • 2
  • L. Jonsson
    • 3
  • A. Zbrozek
    • 4
  1. 1.KI Alzheimer’s Disease Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska institutetStockholmSweden
  2. 2.Aging Research CenterStockholmSweden
  3. 3.i3 Innovus and Karolinska InstitutetStockholmSweden
  4. 4.Wyeth Research IncCollegevilleUSA

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