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通过在日本农村开展创新的健康意识项目,降低认知障碍的发病率和相关成本。

Reduction in the incidence of cognitive impairment and related costs through an innovative health awareness programme in rural Japan.

机构信息

Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Healthcare Consulting Inc., Chiyoda-ku, Tokyo, Japan.

出版信息

PLoS One. 2024 Oct 14;19(10):e0311826. doi: 10.1371/journal.pone.0311826. eCollection 2024.

Abstract

OBJECTIVES

This study examined the impact of the Center of Healthy Aging Program (CHAP) on the cognitive function and economic burden associated with dementia.

METHODS

This observational study utilised Iwaki cohort data. We included participants with mini-mental state examination (MMSE) scores and categorised them into pre- and post-CHAP groups based on their year of entry into the cohort (before 2013 or after) (index year). We defined participants with suspected severe cognitive impairment and suspected mild cognitive impairment using their MMSE scores, with their incidence being the first observation meeting these definitions during the follow-up period. We compared the incidence rates between the pre- and post-CHAP groups using Cox proportional hazard analysis. Medical and caregiving costs were estimated based on the projected number of residents in Iwaki area with suspected mild cognitive impairment and sSCI during hypothetical 10 years of the CHAP implemented or not and compared.

RESULTS

Of the 2,569 participants, 1716 and 853 were included in the pre- and post-CHAP groups, respectively. The incidence rate of suspected mild cognitive impairment was significantly lower in the post-CHAP group even after adjusted known factors associated with cognitive disorders. No cases of suspected severe cognitive impairment occurred in the post-CHAP group during the follow-up period. Estimated costs of JPY 1,628,450 (USD 11562.00 or EUR 10259.24, JPY 100  =  USD 0.71 or EUR 0.63) and JPY 789,560 (USD 5605.88 or EUR 4974.23) per person per year were projected after 10 years with and without the CHAP, respectively.

CONCLUSIONS

We demonstrated a reduction in the incidence rate of suspected mild cognitive impairment among residents who participated in the CHAP and a decrease in the medical and caregiving costs associated with suspected severe cognitive impairment.

摘要

目的

本研究旨在探讨健康老龄化中心(CHAP)计划对与痴呆相关的认知功能和经济负担的影响。

方法

本观察性研究利用了岩木队列数据。我们纳入了接受简易精神状态检查(MMSE)评分的参与者,并根据他们进入队列的年份(2013 年之前或之后)将他们分为 CHAP 前组和 CHAP 后组(索引年)。我们根据 MMSE 评分将疑似严重认知障碍和疑似轻度认知障碍的参与者定义为随访期间首次符合这些定义的观察结果。我们使用 Cox 比例风险分析比较 CHAP 前组和 CHAP 后组的发病率。根据实施或不实施 CHAP 的假设 10 年内岩木地区疑似轻度认知障碍和 sSCI 居民的预计人数估算医疗和护理费用,并进行比较。

结果

在 2569 名参与者中,分别有 1716 名和 853 名参与者纳入 CHAP 前组和 CHAP 后组。即使在调整了与认知障碍相关的已知因素后,CHAP 后组的疑似轻度认知障碍发病率仍显著降低。在随访期间,CHAP 后组未发生疑似严重认知障碍病例。预计在实施和不实施 CHAP 的情况下,实施 CHAP 后 10 年内每人每年的成本分别为 1628450 日元(11562.00 美元或 10259.24 欧元,100 日元=0.71 美元或 0.63 欧元)和 789560 日元(5605.88 美元或 4974.23 欧元)。

结论

我们证明了参加 CHAP 的居民疑似轻度认知障碍的发病率降低,并且与疑似严重认知障碍相关的医疗和护理费用降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d2c/11472916/587491da38a6/pone.0311826.g001.jpg

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