{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:43:54Z","timestamp":1789962234454,"version":"4.0.1"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:p>Background: Alzheimer\u2019s 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\u200a=\u200a3,461). 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\u2019 claims data. The patients were subcategorized into the following three groups according to the MMSE score: mild (21\u2264MMSE\u226430), moderate (11\u2264MMSE\u226420), and severe (0\u2264MMSE\u226410). 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\u00b16.4 years, 76.7% women) in the mild (n\u200a=\u200a53, 84.0\u00b16.9 years, 71.7%), moderate (n\u200a=\u200a118, 86.6\u00b15.9 years, 76.3%), and severe (n\u200a=\u200a116, 86.6\u00b16.5 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.<\/jats:p>","DOI":"10.3233\/jad-201514","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T14:15:01Z","timestamp":1616508901000},"page":"367-374","source":"Crossref","is-referenced-by-count":22,"title":["Impact of the Severity of Alzheimer\u2019s Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan"],"prefix":"10.1177","volume":"81","author":[{"given":"Takumi","family":"Ashizawa","sequence":"first","affiliation":[{"name":"Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, the University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ataru","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, the University of Tokyo, Tokyo, Japan"},{"name":"Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinori","family":"Sakata","sequence":"additional","affiliation":[{"name":"Eisai Co., Ltd. Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mie","family":"Azuma","sequence":"additional","affiliation":[{"name":"Eisai Co., Ltd. Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Eisai Co., Ltd. Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsukasa","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Life Co., Ltd., Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Takase","sequence":"additional","affiliation":[{"name":"Takase Clinic, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunya","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, International University of Health and Welfare, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-201514_ref2","first-page":"459","article-title":"Alzheimer\u2019s disease facts and figures","volume":"12","author":"Alzheimer\u2019s","year":"2016","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-201514_ref4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.neuro.2017.03.006","article-title":"Risk factors associated with the onset and progression of Alzheimer\u2019s disease: A systematic review of the evidence","volume":"61","author":"Hersi","year":"2017","journal-title":"Neurotoxicology"},{"key":"10.3233\/JAD-201514_ref5","doi-asserted-by":"crossref","first-page":"87","DOI":"10.5114\/fn.2019.85929","article-title":"Risk factors for Alzheimer\u2019s disease","volume":"57","author":"Armstrong","year":"2019","journal-title":"Folia Neuropathol"},{"key":"10.3233\/JAD-201514_ref10","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/j.1600-0447.2010.01587.x","article-title":"Trends in prevalence of Alzheimer\u2019s disease and vascular dementia in a Japanese community: The Hisayama Study","volume":"122","author":"Sekita","year":"2010","journal-title":"Acta Psychiatr Scand"},{"key":"10.3233\/JAD-201514_ref11","doi-asserted-by":"crossref","first-page":"962","DOI":"10.5692\/clinicalneurol.52.962","article-title":"Prevalence of dementia in Japan: Past, present and future","volume":"52","author":"Asada","year":"2012","journal-title":"Rinsho Shinkeigaku"},{"key":"10.3233\/JAD-201514_ref12","doi-asserted-by":"crossref","first-page":"e0206508","DOI":"10.1371\/journal.pone.0206508","article-title":"The estimated cost of dementia in Japan, the most aged society in the world","volume":"13","author":"Sado","year":"2018","journal-title":"PLoS One"},{"key":"10.3233\/JAD-201514_ref15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.3233\/JAD-190811","article-title":"Costs and resource use associated with community-dwelling patients with Alzheimer\u2019s disease in Japan: Baseline results from the prospective observational GERAS-J study.","volume":"74","author":"Nakanishi","year":"2020","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-201514_ref16","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 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