Effects on caregiver burden of a donepezil hydrochloride dosage increase to 10 mg/day in patients with Alzheimer’s disease

Figures & data

Table 1 Checklist of patient behavior in daily life

Please choose one option to answer each question about the patient’s daily life
Question		FAST stage
Q1	Does the patient sometimes seem unsure about dates, seasons, or places? (Time and place)
	Some uncertainty about dates (year, month, day) (understands mostly)	4
	Sometimes does not know the season or place, but can answer if given a hint	5
	Does not know where places are, such as the toilet, inside the house	6
Q2	Does the patient need help communicating, such as during conversation? (Speech)
	No help is required for daily conversations and knowledge is retained	4
	Can communicate what is necessary, understands simple conversations	5
	Understands simple conversations, but does not request anything on his/her own	5
	Does not understand simple conversations, but is able to express his/her emotions to some degree	6
Q3	Does the patient bathe on his/her own? (Bathing)
	He/she can bathe on his/her own	4
	Sometimes forgets to bathe but is able to wash himself/herself and adjust the water temperature	5
	Unable to bathe properly without help (unable to adjust the water temperature or amount, unable to wash own body well)	6
Q4	Does the patient select his/her clothing and dress him/herself? (Dressing)
	Able to choose own clothing and dress without help	4
	If assisted and appropriate clothing is presented, then he/she can dress him/herself	5
	Unable to choose appropriate clothing and unable to dress him/herself without assistance	6
Q5	Does the patient have accidents in the toilet? (Toileting)
	Able to use toilet on his/her own	4
	Forgets to flush the toilet or to wipe him/herself	6

Abbreviation: FAST, functional assessment staging.

Table 2 Japanese version of the Zarit Caregiver Burden Interview

			Never	Rarely	Sometimes	Frequently	Almost always
A	Q1	Do you feel embarrassed by the patient’s behavior?	0	1	2	3	4
A	Q2	Do you feel angry when you are around the patient?	0	1	2	3	4
B	Q3	Do you feel that the patient currently affects your relationships with family members or friends in a negative way?	0	1	2	3	4
A	Q4	Do you feel any strain when you are around the patient?	0	1	2	3	4
B	Q5	Do you feel that your social life has suffered because you are caring for the patient?	0	1	2	3	4
B	Q6	Do you feel uncomfortable about having friends over because of the patient?	0	1	2	3	4
A	Q7	Do you wish you could leave the care of the patient to someone else?	0	1	2	3	4
A	Q8	Do you feel uncertain about what to do about the patient?	0	1	2	3	4

Notes: Japanese version of the Zarit Caregiver Burden Interview consists of eight question items (Q), each scored on a five-point scale (0–4). Five items address personal strain (indicated by A) and three address role strain (indicated by B).

Figure 1 Improvement in dementia severity stage following the increase in donepezil to 10 mg/day.

Note: Values are expressed as the number of patients with Alzheimer’s disease evaluated as showing improvement (n=27).

Table 3 Changes in scores on the Japanese version of the Zarit Caregiver Burden Interview

	Patients (n)	J-ZBI_8 score					Change at week 16 from week 0
		Week 0	Week 4	Week 8	Week 12	Week 16
J-ZBI_8 (personal strain)	27	5.15±3.76 (25.8%)	3.89±3.42* (19.4%)	3.22±3.42** (16.1%)	3.41±3.65** (17.1%)	3.59±3.90** (18.0%)	−1.56±2.59 (−7.8%)
J-ZBI_8 (role strain)	27	2.19±2.80 (18.3%)	1.85±2.88 (15.4%)	1.56±2.64* (13.0%)	1.81±2.83 (15.1%)	2.07±3.16 (17.3%)	−0.11±1.55 (−0.9%)

Notes: Data are expressed as the mean ± standard deviation.

* P<0.05,

** P<0.01 (versus week 0), Wilcoxon signed rank test. The evaluation method of the J-ZBI_8 entails adding scores from each time point. The higher the total score, the heavier the caregiver burden. The maximum score for caregiver burden is 20 points (four points × five items) for personal strain and 12 points (four points × three items) for role strain. Values in parentheses indicate the rate in relation to the highest score for each item.

Abbreviation: J-ZBI_8, the Japanese version of the Zarit Caregiver Burden Interview.

Table 4 Changes in swallowing function as assessed by the RSST

Swallowing function	Patients (n)	Week 0	Week 4	Week 8	Week 12	Week 16
Normal (RSST score ≥3) (count/30 seconds)	8	4.38±1.30	4.50±0.93	4.25±0.71	4.50±1.69	4.25±1.58
Impaired (RSST score ≤2) (count/30 seconds)	9	1.22±0.67	2.78±1.72*	3.22±1.48*	2.33±1.32*	2.78±1.79*

Notes: Data are expressed as the mean ± standard deviation.

* P<0.05 (versus week 0), Wilcoxon signed-rank test. Subjects with RSST score ≥3 (three or more swallows in 30 seconds) were classified into the normal swallowing group and those with a score ≤2 (two or fewer swallows in 30 seconds) into the impaired swallowing group.

Abbreviation: RSST, Repetitive Saliva Swallowing Test.