Use of day services improved cognitive function in patients with Alzheimer's disease

Honjo, Yasuko; Ide, Kazuki; Takechi, Hajime

doi:10.1111/psyg.12558

Cited by 8 publications

(14 citation statements)

References 20 publications

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“…As apathy is a major symptom of AD, people with AD are generally reluctant to attend DS centres. In our previous study, approximately one‐third of patients with AD chose not to participate in DS 13 . We also observed this tendency in the present study, where DS users were mostly older women with moderate to severe dementia.…”

Section: Discussionsupporting

confidence: 81%

“…This study found more frequent DS use per week was significantly positively related to HDS-R score changes, whereas our previous study found no such significant relationship with MMSE score changes. 13 Because this discrepancy might be related to the difference in items on these cognitive instruments, we examined specifically which HDS-R items showed improvement. Serial 7 scores showed significant improvement among DS users.…”

Section: Discussionmentioning

confidence: 99%

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Day service use and improved Serial 7 and Verbal fluency scores in patients with Alzheimer's disease

2022

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Background Day services (DS) are provided as part of the Japanese public nursing care system. Recent studies have suggested a possible relationship between DS use and limited progression of Alzheimer's disease (AD). This study examined in detail the relationship between improvements in cognitive function and DS use in people with AD. Methods We retrospectively analysed Revised Hasegawa Dementia Scale (HDS‐R) scores of 208 patients with AD at five memory clinics over a 6‐month period. The patients were divided into a group that started using DS (n = 132) and a group that did not (n = 76) during the study period. We then compared each participant's total and item scores on the HDS‐R between the first clinic visit and 6 months later also compared scores between DS users and non‐users. Results DS non‐users were younger, predominantly male, had longer school education, and better total HDS‐R score at the first visit. After 6 months, DS users showed significantly improved total HDS‐R score and individual Serial 7 and Verbal fluency scores. Immediate memory scores were comparable between the first visit and after 6 months. Among the DS users, more frequent participation in DS was significantly associated with improved total HDS‐R score. Conclusions DS use was significantly associated with improved HDS‐R scores, especially for the Serial 7 and Verbal fluency tasks, and there was no deterioration in Immediate memory score. These results suggest the usefulness of DS participation as a non‐pharmacological therapy.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Day service use and improved Serial 7 and Verbal fluency scores in patients with Alzheimer's disease

2022

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“…12 Recently, the HDS-R and MMSE have also been used for regular cognitive assessment of AD patients. 15,16 For the family assessments of AD stage, we used the Functional Assessment Staging (FAST) scale, 17 which classifies AD progression into seven stages. We then compared the discrepancy between FAST-based family-assessed AD stage and diagnosed AD stage.…”

Section: Introductionmentioning

confidence: 99%

“…Both are commonly used screening assessments in Japan, although the HDS‐R was found to be superior to the MMSE as a screening instrument for AD in a previous study 12 . Recently, the HDS‐R and MMSE have also been used for regular cognitive assessment of AD patients 15,16 . For the family assessments of AD stage, we used the Functional Assessment Staging (FAST) scale, 17 which classifies AD progression into seven stages.…”

Section: Introductionmentioning

confidence: 99%

Most families tend to realize progress of Alzheimer's disease when behavioural and psychological symptoms are obvious

2022

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Background Alzheimer's disease (AD) is a common cognitive disease that can progress at an accelerating rate. Even with early diagnosis, the families might not recognize AD progressing unless behavioural and psychological symptoms of dementia (BPSD) develop. In many cases, discrepancies could exist between family‐assessed AD stage and diagnosed AD stage. This study explored such discrepancies and potential clinical implications. Methods Participants were 161 new outpatients with AD or mild cognitive impairment at four memory clinics whose AD stage was diagnosed using the Revised Hasegawa Dementia Scale (HDS‐R) and Mini‐Mental State Examination (MMSE). We classified patients into four groups according to AD severity. Family members completed the Functional Assessment Staging (FAST) scale during an interview. We then assigned patients to three groups according to discrepancies between family‐assessed and diagnosed AD stage. Families also completed the Neuropsychiatric Inventory Questionnaire (NPI‐Q), which assesses 12 neuropsychiatric domains, in order to examine the presence of BPSD in relation to AD stage. Results Most families (74%–80%) assessed patients as having milder AD than the diagnosed stage. NPI‐Q scores and duration of education significantly affected discrepancies with HDS‐R and MMSE scores. The NPI‐Q domains of anxiety, apathy/indifference, aberrant motor behaviours, and appetite/eating disturbance significantly affected family‐assessed FAST. Families of patients with more years of education assessed the AD stage as more advanced than the diagnosed stage. Surprisingly, living together did not significantly affect the discrepancy. Conclusions Most families assessed AD as milder than the clinically diagnosed AD stage. In addition, high NPI‐Q scores and more years of school education significantly affected the discrepancy. Family‐assessed FAST was significantly affected by the NPI‐Q domains of anxiety, apathy/indifference, aberrant motor behaviours, and appetite/eating disturbance. These results suggest that obvious BPSD are significant factors for Japanese families to recognize AD progress.

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“…Of relevance, Suspected Non-Alzheimer's Disease Pathophysiology is seen in 17% to 35% of patients with mild cognitive impairment, and 7% to 39% of patients with clinically probable AD do not exhibit beta amyloid pathology [38]. Recently suppressed AD progression has been reported by appropriate pharmacological management [39] as well as non-pharmacological management by social care use such as daycare [40] in Japan. Memory clinic settings and a high proportion of daycare use would cause suppressed AD progression in this study population.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Costs and resource use of community-dwelling patients with Alzheimer’s disease in Japan: 18-month results from the GERAS-J study

Nakanishi

Igarashi

Ueda

et al. 2021

Current Medical Research and Opinion

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Objective: To determine the longitudinal societal costs and burden of community-dwelling patients with Alzheimer's disease (AD) and their caregivers in Japan.Methods: GERAS-J was an 18-month, prospective, longitudinal, observational study. Using the Mini-Mental State Examination (MMSE), patients routinely visiting memory clinics were stratified into groups based on AD severity at baseline (mild, moderate, and moderately severe/severe [MS/S]). Healthcare resource utilization and caregiver burden were assessed using the Resource Utilization in Dementia and Zarit "Caregiver" Burden Interview questionnaires, respectively. Total monthly societal costs were estimated using Japan-specific unit costs of services and products (patient direct healthcare use, patient social care use, and informal caregiving time).Results: Overall, 553 patients (156 mild; 209 moderate; 188 MS/S) were enrolled. MMSE scores declined (1.73, 1.38, and 0.95 points for the mild, moderate, and MS/S AD groups, respectively) and caregiver burden and resource utilization increased over 18 months in each of the AD severity groups. Cumulative total societal costs per patient over 18 months were 3.1, 3.8, and 5.3 million Japanese yen (29,006, 35,662, and 49,725 USD) for mild, moderate, and MS/S AD, respectively. Both patient social care costs and caregiver informal care costs increased with baseline disease severity, with >50% of total costs due to caregiver informal care in each disease severity subgroup. A c c e p t e d M a n u s c r i p tConclusions: Total treatment costs increased with AD severity over 18 months due to increases in both patient social care costs and caregiver informal care costs. Our data suggest current social care services in Japan are insufficient to alleviate the negative impact of AD on caregiver burden.

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Use of day services improved cognitive function in patients with Alzheimer's disease

Cited by 8 publications

References 20 publications

Day service use and improved Serial 7 and Verbal fluency scores in patients with Alzheimer's disease

Day service use and improved Serial 7 and Verbal fluency scores in patients with Alzheimer's disease

Most families tend to realize progress of Alzheimer's disease when behavioural and psychological symptoms are obvious

Costs and resource use of community-dwelling patients with Alzheimer’s disease in Japan: 18-month results from the GERAS-J study

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