Mental Health and Nursing Research Team, Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan, and Yokohama City University, Yokohama, Japan.
J Alzheimers Dis. 2020;74(1):127-138. doi: 10.3233/JAD-190811.
As the Japanese population ages, caring for people with Alzheimer's disease (AD) dementia is becoming a major socioeconomic issue.
To determine the contribution of patient and caregiver costs to total societal costs associated with AD dementia.
Baseline data was used from the longitudinal, observational GERAS-J study. Using the Mini-Mental State Examination (MMSE) score, patients routinely visiting memory clinics were stratified into three groups based on AD severity. Health care resource utilizationwas recorded using the Resource Utilization in Dementia questionnaire. Total monthly societal costs were estimated using Japan-specific unit costs of services and products (patient direct health care use, patient social care use, and informal caregiving time). Uncertainty around mean costs was estimated using bootstrapping methods.
Overall, 553 community-dwelling patients withADdementia (28.3% mild[MMSE21-26], 37.8% moderate[MMSE 15-20], and 34.0% moderately severe/severe [MMSE < 14]) and their caregivers were enrolled. Patient characteristics were: mean age 80.3 years, 72.7% female, and 13.6% living alone. Caregiver characteristics were: mean age 62.1 years, 70.7% female, 78.8% living with patient, 49.0% child of patient, and 39.2% sole caregiver. Total monthly societal costs of AD dementia (Japanese yen) were: 158,454 (mild), 211,301 (moderate), and 294,224 (moderately severe/severe). Informal caregiving costs comprised over 50% of total costs.
Baseline results of GERAS-J showed that total monthly societal costs associated with AD dementia increased with AD severity. Caregiver-related costs were the largest cost component. Interventions are needed to decrease informal costs and decrease caregiver burden.
随着日本人口老龄化，照顾患有阿尔茨海默病（AD）痴呆症的人成为一个主要的社会经济问题。
确定患者和照护者成本对与 AD 痴呆症相关的总社会成本的贡献。
使用纵向观察性 GERAS-J 研究的基线数据。根据 AD 严重程度，使用简易精神状态检查（MMSE）评分将常规就诊于记忆诊所的患者分为三组。使用资源利用在痴呆症问卷记录卫生保健资源利用情况。使用特定于日本的服务和产品单位成本（患者直接医疗保健使用、患者社会护理使用和非正式护理时间）估算总月社会成本。使用自举方法估算平均成本的不确定性。
共有 553 名居住在社区的 AD 痴呆症患者（28.3%轻度[MMSE21-26]，37.8%中度[MMSE15-20]，34.0%中重度/重度[MMSE < 14]）及其照护者参与了研究。患者特征为：平均年龄 80.3 岁，72.7%为女性，13.6%独居。照护者特征为：平均年龄 62.1 岁，70.7%为女性，78.8%与患者同住，49.0%为患者的子女，39.2%为唯一照护者。AD 痴呆症的总月社会成本（日元）为：轻度 158454 日元，中度 211301 日元，中重度/重度 294224 日元。非正式护理成本占总费用的 50%以上。
GERAS-J 的基线结果表明，与 AD 痴呆症相关的总月社会成本随 AD 严重程度的增加而增加。与照护者相关的成本是最大的成本组成部分。需要采取干预措施来降低非正式成本并减轻照护者的负担。
