{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T06:10:02Z","timestamp":1756793402907,"version":"3.44.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K10653"],"award-info":[{"award-number":["JP24K10653"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP23dk0207048","JP24dk0207054"],"award-info":[{"award-number":["JP23dk0207048","JP24dk0207054"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer's Disease Reports"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Dementia insurance, a private insurance product covering the first diagnosis of dementia of the insured, may be beneficial for asymptomatic individuals who recognize their own high genetic risk for Alzheimer's disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>\n              We aimed to examine the cost-benefit of dementia insurance in cognitively unimpaired individuals, stratified by\n              <jats:italic>APOE<\/jats:italic>\n              \u03b54 genotype.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>\n              A simulation study using 18 years of longitudinal data from National Alzheimer's Coordinating Center study to simulate the income and expenses of dementia insurance from the insured's perspective. Cognitively unimpaired participants at baseline (approximately n\u2009=\u20099000) were included, and the loss ratio (= total benefits gained \/ total premium paid) was calculated by\n              <jats:italic>APOE<\/jats:italic>\n              \u03b54 subgroup, applying the premium rates of actual insurance products in Japan.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>\n              For individuals aged 60 or older with\u2009\u2265\u200910-year follow-up, the estimated loss ratio was highest in\n              <jats:italic>APOE<\/jats:italic>\n              \u03b54 homozygotes. However, even for this group, the 95% confidence interval for the loss ratio was either below or included 1.0, indicating no clear financial gain. Their loss ratio was approximately 3 to 4 times higher than for \u03b54-negative individuals, and 2 times higher than for \u03b54-heterozygotes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Dementia insurance may be relatively more cost-beneficial for asymptomatic \u03b54-homozygotes in their 60\u2005s or older compared to other genotypes over policy periods of 10 years or longer. However, it does not represent a clear financial gain for the insured, highlighting the need for careful consideration. Our study provides an important basis for further investigating the advantages and limitations of dementia insurance for individuals with high-risk gene.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/25424823251372925","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T05:28:03Z","timestamp":1756790883000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-benefit of dementia insurance for cognitively-unimpaired\n            <i>APOE<\/i>\n            \u03b54 homozygotes: A simulation study"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-9526","authenticated-orcid":false,"given":"Kenichiro","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"},{"name":"Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan"},{"name":"Dementia Inclusion and Therapeutics, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saki","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Niimi","sequence":"additional","affiliation":[{"name":"Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan"},{"name":"Dementia Inclusion and Therapeutics, The University of Tokyo Hospital, Tokyo, Japan"},{"name":"Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoko","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Iwatsubo","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"},{"name":"Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo, Japan"},{"name":"Dementia Inclusion and Therapeutics, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"162","article-title":"Dementia and life insurance \u223cdevelopment and background of dementia insurance products","volume":"118","author":"Yamazaki H","year":"2020","unstructured":"Yamazaki H. Dementia and life insurance \u223cdevelopment and background of dementia insurance products. Japan J Insurance Med 2020; 118: 162\u2013171. [Article in Japanese].","journal-title":"Japan J Insurance Med"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.12779\/dnd.2017.16.1.1"},{"key":"e_1_3_3_4_2","unstructured":"Reinsurance Group of America. South Korea Provides a Road Map for Dementia Insurance https:\/\/www.rgare.com\/knowledge-center\/article\/south-korea-provides-a-road-map-for-dementia-insurance (2024 accessed 1 July 2024)."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1515\/humaff-2020-0033"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.14716\/ijtech.v11i8.4543"},{"key":"e_1_3_3_7_2","unstructured":"Eisai Global. Lifenet and Eisai Co-Develop Dementia Insurance \u201cbe\u201d https:\/\/www.eisai.com\/news\/2024\/news202416.html (2024 accessed 30 September 2024)."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnr067"},{"key":"e_1_3_3_9_2","unstructured":"Japan Population Census. Ministry of Internal Affairs and Communications https:\/\/www.e-stat.go.jp\/stat-search\/files?toukei=00200524 (2021 accessed 1 July 2024). [Article in Japanese]."},{"key":"e_1_3_3_10_2","unstructured":"Japan Institute of Life Insurance. 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