日本阿尔茨海默病严重程度对接受抗阿尔茨海默病药物治疗的住院患者生活质量、日常生活活动能力和护理费用的影响。
Impact of the Severity of Alzheimer's Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan.
机构信息
Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, the University of Tokyo, Tokyo, Japan.
Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Kanagawa, Japan.
出版信息
J Alzheimers Dis. 2021;81(1):367-374. doi: 10.3233/JAD-201514.
BACKGROUND
Alzheimer's disease (AD) increases societal costs and decreases the activities of daily living (ADL) and quality of life (QoL) of the affected individuals.
OBJECTIVE
We assess the impact of AD severity on ADL, QoL, and caregiving costs in Japanese facilities for the elderly.
METHODS
Patients with AD in facilities for the elderly were included (47 facilities, N = 3,461). The QoL, ADL, and disease severity of patients were assessed using Barthel Index (BI), EuroQoL-5D-5L (EQ-5D-5L), and Mini-Mental State Examination (MMSE), respectively. Annual caregiving costs were estimated using patients' claims data. The patients were subcategorized into the following three groups according to the MMSE score: mild (21≤MMSE≤30), moderate (11≤MMSE≤20), and severe (0≤MMSE≤10). Changes among the three groups were evaluated using the Jonckheere-Terpstra test.
RESULTS
Four hundred and one participants were on anti-AD medicines, of whom 287 (age: 86.1±6.4 years, 76.7% women) in the mild (n = 53, 84.0±6.9 years, 71.7%), moderate (n = 118, 86.6±5.9 years, 76.3%), and severe (n = 116, 86.6±6.5 years, 79.3%) groups completed the study questionnaires. The mean BI and EQ-5D-5L scores for each group were 83.6, 65.1, and 32.8 and 0.801, 0.662, and 0.436, respectively. The mean annual caregiving costs were 2.111, 2.470, and 2.809 million JPY, respectively. As AD worsened, the BI and EQ-5D-5L scores decreased and annual caregiving costs increased significantly.
CONCLUSION
AD severity has an impact on QoL, ADL, and caregiving costs.
背景
阿尔茨海默病（AD）增加了社会成本，并降低了受影响个体的日常生活活动（ADL）和生活质量（QoL）。
目的
我们评估 AD 严重程度对日本老年人护理机构中 ADL、QoL 和护理费用的影响。
方法
纳入老年人护理机构中的 AD 患者（47 家机构，N=3461 例）。使用 Barthel 指数（BI）、EuroQoL-5D-5L（EQ-5D-5L）和简易精神状态检查（MMSE）分别评估患者的 QoL、ADL 和疾病严重程度。使用患者的理赔数据估算每年的护理费用。根据 MMSE 评分，患者分为以下三组：轻度（21≤MMSE≤30）、中度（11≤MMSE≤20）和重度（0≤MMSE≤10）。使用 Jonckheere-Terpstra 检验评估三组之间的变化。
结果
401 名参与者正在服用抗 AD 药物，其中 287 名（年龄：86.1±6.4 岁，76.7%女性）在轻度（n=53，84.0±6.9 岁，71.7%）、中度（n=118，86.6±5.9 岁，76.3%）和重度（n=116，86.6±6.5 岁，79.3%）组完成了研究问卷。每组的平均 BI 和 EQ-5D-5L 评分分别为 83.6、65.1 和 32.8 和 0.801、0.662 和 0.436。平均每年的护理费用分别为 211.1、247.0 和 2809 万日元。随着 AD 的恶化，BI 和 EQ-5D-5L 评分下降，年护理费用显著增加。
结论
AD 严重程度对 QoL、ADL 和护理费用有影响。
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