Increase in direct social care costs of Alzheimer's disease in Japan depending on dementia severity

Abstract

Aim With the aging population, costs of direct social support for patients with Alzheimer's disease have grown and will continue to increase. The purpose of the present study was to estimate the cost of direct social support for Alzheimer's disease under long‐term care insurance in Japan. Methods This cross‐sectional study included 169 patients with Alzheimer's disease or mild cognitive impairment who visited a memory clinic and were followed over time. Dementia severity, use of care services and costs were analyzed. Results The use of direct social support and costs increased significantly between patients with mild, moderate and severe dementia (P < 0.001). In particular, the use of day services and short stay services increased with the severity of dementia (P < 0.001). Similar findings were obtained when participants were stratified by long‐term care insurance care levels. Of 169 participants, 49 had not applied for long‐term care insurance, although their dementia severity was not different from support‐need level 1 and care‐need level 1. Logistic regression analysis of “did not apply” and “applied and certified” groups showed significant differences not only in dementia severity, but also in age (odds ratio 1.112, 95% confidence interval 1.037–1.193, P = 0.003) and living arrangements (odds ratio 0.257, 95% confidence interval 0.076–0.862, P = 0.028). Conclusions As the number of patients with Alzheimer's disease increases, direct social costs will increase. The findings of this study might help standardize the type of direct social support provided after diagnosis of Alzheimer's disease and contribute to the development of cost‐effective care for these patients. Geriatr Gerontol Int 2019; 19: 1023–1029.

Development of an assessment scale for engagement in activities for patients with moderate to severe dementia

“…The number of people with dementia has increased in East Asia and these areas, including Japan, face a great burden and need further studies to guide medical and non‐medical interventions 1 . Dementia occurs along a disease state continuum between mild and severe; many people with severe dementia have a strong onset of behavioural and psychological symptoms of dementia and are often institutionalised or hospitalised to treat the psychiatric symptoms 2 . Moreover, they have much higher care costs and care burdens than people with mild dementia 3 …”

“…1 Dementia occurs along a disease state continuum between mild and severe; many people with severe dementia have a strong onset of behavioural and psychological symptoms of dementia and are often institutionalised or hospitalised to treat the psychiatric symptoms. 2 Moreover, they have much higher care costs and care burdens than people with mild dementia. 3 Therefore, it is necessary to rehabilitate the patient according to the severity of the disease.…”

The Humanistic and Economic Burden of Alzheimer's Disease

“…Studies from six countries reported on direct medical costs, which varied from $531 (China) to $1473 (USA), €171 (Spain) to €313 (France and Spain), £365 (UK), and JPY 26,744 (Japan) [ 6 , 44 , 63 – 65 , 81 , 85 ]. Finally, direct non-medical costs (i.e., social care costs such as home health assistance, community care, skilled nursing facility care, consumables), reported in five countries, were €141 to €589 (Spain), €1398 (meta-analysis of France and Spain), £975 (UK), $258 (China), and JPY 69,179 to JPY 81,970 (Japan) [ 6 , 44 , 63 – 65 , 81 , 86 ]. Among studies reporting on direct medical and non-medical costs, three studies and a meta-analysis reported that non-medical costs were higher (£975 vs. £365 in a UK study, €589 vs. €289 in a Spanish study, JPY 69,179 vs. JPY 26,744 in a Japanese study, and €1398 vs. €313 in a meta-analysis), whereas two studies reported that direct medical costs were higher than non-medical costs (€171 vs. €141 in another Spanish study and $1055 vs. $424 in a Chinese study).…”

“…Dependence level and cognitive decline have been associated with direct costs [ 70 , 73 – 75 , 81 , 86 ]. Studies conducted in France, Spain, Japan, the UK, and the USA found that as the level of functional dependence increased, direct costs also rose [ 70 , 73 – 75 , 81 , 86 ].…”

“…Dependence level and cognitive decline have been associated with direct costs [ 70 , 73 – 75 , 81 , 86 ]. Studies conducted in France, Spain, Japan, the UK, and the USA found that as the level of functional dependence increased, direct costs also rose [ 70 , 73 – 75 , 81 , 86 ]. In the US study, which used the DS to stratify the patient population into six dependence levels from very mild to very severe, total direct, direct medical, and direct non-medical (i.e., social care) costs rose with increasing dependence, with the steepest rise seen in the non-medical costs related to long-term care [ 75 ].…”