Sato Kengo, Shioda Katsutoshi, Suda Shiro
Department of Psychiatry, Jichi Medical University, Tochigi, Japan.
Cocoro Care Center, Jichi Medical University, Tochigi, Japan.
Neuropsychiatr Dis Treat. 2025 Jul 5;21:1325-1337. doi: 10.2147/NDT.S520892. eCollection 2025.
Dementia, including Alzheimer's disease (AD), is a leading cause of mortality in Europe and the United States. Interestingly, while Japan is recognized for its high life expectancy, dementia-related diseases account for a comparatively lower proportion of recorded deaths. This study aimed to investigate the actual mortality attributed to clinically diagnosed AD in Japan, particularly in psychiatric hospital settings.
Total 653 cases Death certificates and medical records from psychiatric hospitals in Japan were analyzed to investigate the actual death rate associated with dementia diseases.
In total, 134 of the 653 cases (20.5%) were determined to have AD as the direct cause of death, a significant increase from the 34 cases initially identified from death certificates alone (P<0.01). And more, after reviewing the death certificates and medical records of 653 patients, 203 (134 with AD and 69 with other dementias) were identified as having dementia as the direct cause of death, representing 31.1% of all deaths. This rate was significantly higher than the rate identified before the medical record review (P<0.01). Dementia diagnoses were frequently omitted from death certificates, with complications often recorded as the primary cause of death. This suggests that the true incidence of dementia-related mortality in Japan may be approximately four times higher than reported.
We found that the true incidence of dementia-related mortality in Japan may be higher than reported. These findings underscore the critical need to increase awareness about dementia as a cause of death and to educate the public and healthcare professionals on accurately documenting it on death certificates.
痴呆症，包括阿尔茨海默病（AD），是欧美地区主要的死亡原因。有趣的是，尽管日本以高预期寿命而闻名，但与痴呆症相关的疾病在记录的死亡中所占比例相对较低。本研究旨在调查日本临床诊断为AD的实际死亡率，特别是在精神病院环境中的情况。
分析了日本精神病院的653份死亡证明和病历，以调查与痴呆症相关疾病的实际死亡率。
在653例病例中，共有134例（20.5%）被确定AD为直接死亡原因，这一数字较最初仅从死亡证明中确定的34例有显著增加（P<0.01）。此外，在审查了653名患者的死亡证明和病历后，有203例（134例为AD，69例为其他痴呆症）被确定痴呆为直接死亡原因，占所有死亡人数的31.1%。这一比例显著高于病历审查前确定的比例（P<0.01）。死亡证明中经常遗漏痴呆症诊断，并发症常被记录为主要死亡原因。这表明日本痴呆症相关死亡率的实际发生率可能比报告的高出约四倍。
我们发现日本痴呆症相关死亡率的实际发生率可能高于报告的数字。这些发现强调了提高对痴呆症作为死亡原因的认识以及教育公众和医疗保健专业人员在死亡证明上准确记录的迫切需求。
