OBJECTIVES:

Alzheimer’s disease dementia (ADD) was ranked as the leading cause of long-term care in Japan. This study aimed to conduct literature review on the burden of ADD and to estimate the annual healthcare and long-term care costs in FY2018 for people over 65 years old living with ADD in Japan and productivity loss for their family.

METHODS:

Annual healthcare costs and long-term care costs for ADD were estimated using the literature obtained through MEDLINE, Ichushi-Web, and the MHLW Grants system. The healthcare and long-term care costs covered by the Japanese National Health Insurance were included according to the disease severity classified with clinical dementia rating (CDR) score. Productivity loss was sum up with income loss based on overall work impairment, turnover, and activity impairment in housewives due to informal care for ADD.

RESULTS:

There were around 3.6 million people with ADD in Japan, which accounted for 10% of the population over 65 years old. The total annual healthcare costs of ADD were 1,073 billion JPY (8.9 billion Euro), of which 86% (923 billion JPY) was attributed to medical costs, and 14% (151 billion JPY) was costs for drug treatments. The annual medical costs by severity were less than 200 billion JPY for patients with CDR-0.5, CDR-1, and CDR-2, respectively, but increased to 447 billion JPY (48%) for patients with CDR-3. The annual public long-term care costs were estimated to be 4,783 billion JPY, which increased as severity worsened from 242 billion JPY for CDR-0.5 (5%), 1,059 billion for CDR-1 (22%), 1,183 billion for CDR-2 (25%) to 2,299 billion for CDR-3 (48%) JPY, respectively. Total productivity loss was 1,436 billion JPY.

CONCLUSIONS:

Costs of ADD have huge impact on the public funded healthcare and long-term care system and their family in Japan. Effective interventions in any levels are required to mitigate this societal issues.