Detection, diagnosis, and treatment of Alzheimer’s disease dementia stratified by severity as reported by caregivers in Japan

Abstract

Background

Dementia of Alzheimer’s disease (AD) imposes burdens on patients, caregivers, and society. This cross-sectional study examined caregiver-reported history of disease onset and AD dementia to inform efforts promoting early disease detection and diagnosis.

Methods

An online survey collected self-reported cross-sectional data – demographic characteristics, diagnosis, treatment experiences, and other information on disease detection, diagnosis, and treatment – from caregivers of patients with AD dementia. These characteristics were examined as a function of AD dementia severity.

Results

Three hundred patients with AD dementia were trichotomized by long-term care insurance levels reported by caregivers: 12.3% (n=37) as low severity, 63.7% (n=191) as medium severity, and 24.0% (n=72) as high severity. The Short-Memory Questionnaire and patient dependency scores both varied significantly across severity groups. AD dementia symptoms were most frequently first detected by a caregiver (58.7%) or the patient’s family (45.7%). However, in 13.7% of cases, symptoms were detected by a health care provider during a routine visit. Memory problems were the most frequent first symptoms (77.3%), followed by repetition (55.7%). Patients (73.7%) were taking symptomatic treatment such as acetylcholinesterase inhibitors or memantine. High-severity patients were older, had been diagnosed with AD dementia for a longer time, had more frequent reports of memory problems as the first symptoms detected, and required more hours of care per day, compared with low-severity patients.

Conclusion

Caregivers and families play an integral role in the identification of AD dementia patients, with memory problems being common first symptoms noticed by caregivers that led to a diagnosis of AD dementia. These results provide novel insight into the detection, diagnosis, and treatment of AD dementia in Japan and how these factors differ across the spectrum of disease severity.

Keywords:

• Alzheimer’s disease dementia
• Japan
• disease history
• caregivers
• treatment pattern

Acknowledgments

The authors acknowledge Errol J Philip, PhD, for assistance with literature review and writing, and Colleen M Carpinella, PhD, and Michael J Doane, PhD, of Kantar Health, for their assistance with writing, analysis, and interpretation. This study, the manuscript writing services, and publication fees were funded by Eli Lilly and Company (Indianapolis, IN, US). Results contained in this paper were presented at the 32nd International Conference of Alzheimer’s Disease International. The presentation was entitled: “Understanding Symptom Presentation, Recognition and Diagnosis for People with Alzheimer’s Disease in Japan.”

Disclosure

William Montgomery, Tomomi Nakamura, Kaname Ueda, and Kristin Kahle-Wrobleski were full-time employees of Eli Lilly and Company at the time of this study. Amir Goren is an employee of Kantar Health, which conducted this study with funding from Eli Lilly. The authors report no other conflicts of interest in this work.

Author contributions

All authors contributed to study design, data analysis, and drafting and revision of the paper, and all authors agree to be accountable for all aspects of the work. Amir Goren conducted the statistical analyses.