scholarly journals Impact of the Severity of Alzheimer’s Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan

2021 ◽  
pp. 1-8
Author(s):  
Takumi Ashizawa ◽  
Ataru Igarashi ◽  
Yukinori Sakata ◽  
Mie Azuma ◽  
Kenichi Fujimoto ◽  
...  

Background: Alzheimer’s 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 = 3,461). 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’ claims data. The patients were subcategorized into the following three groups according to the MMSE score: mild (21≤MMSE≤30), moderate (11≤MMSE≤20), and severe (0≤MMSE≤10). 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±6.4 years, 76.7% women) in the mild (n = 53, 84.0±6.9 years, 71.7%), moderate (n = 118, 86.6±5.9 years, 76.3%), and severe (n = 116, 86.6±6.5 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.

2021 ◽  
Author(s):  
Daniele Sutherland W. Rizziolli ◽  
Ana Maria Ramos Miranda ◽  
Andressa Schimidt do Nascimento ◽  
Cristiane dos Santos Lima ◽  
Jade Menezes Maia ◽  
...  

Introduction: With the increase in life expectancy, there is an increase in Alzheimer’s Disease (AD). Characterized by being a degenerative and irreversible neurological disease, that leads to developing a dependence for daily activities. Objective:To analyze the impact of AD on the quality of life and daily activities of the elderly. Methodology:Integrative literature review, with bibliographic survey carried out on an international basis (PUBMED). Criteria for the selection of articles was: be published in English, in the period 2018-2020, available in full, whose theme was “Impacts on the quality of life that AD causes in the elderly”. Results: For the sample of this review 59 articles were selected, of which 48 articles were not specific to the topic, leaving a final sample of 11 articles included in the review. Identifying that AD has a strong impact on patient’s quality of life, such as reduced autonomy and dependence on daily activities. Conclusion: It was observed that there is a reduction in the quality of life of patients with AD, related to loss of autonomy and dependence in daily activities. Mesh- Terms: Degenerative Disease, Aged, Insanity.


Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1067
Author(s):  
Elvan Felekoğlu ◽  
Sevgi Özalevli ◽  
Hazal Yakut ◽  
Rıdvan Aktan ◽  
Görsev Yener

Background and Objectives: As with other chronic diseases with limited medical treatment, the most important goal of Alzheimer’s disease (AD) treatment is to provide a better quality of life (QoL). The purpose of this study was to investigate the factors affecting the QoL of patients with mild to moderate AD in terms of patients and caregivers. Materials and Methods: Seventy-three home-dwelling patients with AD and their caregivers participated in this prospective, cross-sectional study. The patients were asked about their cognition, depression and a self-rating part of a QoL questionnaire. The caregivers were asked about their patients’ sociodemographic information, sleepiness, activities of daily living and a proxy rating part of a QoL questionnaire. Results: The self-rated QoL was higher than that provided by the proxy rating. Cognition (p = 0.02), sleepiness (p < 0.01) and depression (p = 0.03) were correlated with the self-rated QoL, while the patient’s independence level in activities of daily living was correlated with the proxy-rated QoL (p < 0.05). In regard to predicting QoL according to linear regression analysis, the following were statistically significant: depression was for total score, depression and cognition were for the self-rating and instrumental activities of daily living was for the proxy rating (p < 0.01). Conclusions: While individual factors such as psychology are an important determinant of QoL for patients with AD, objective conditions such as the independence of the patient in daily life are important for the caregiver. While evaluating the quality of life of AD patients, it is important to remember that patients and caregivers have different priorities, and the priorities of both should be taken into account when planning a treatment program.


2021 ◽  
Author(s):  
Elvan Felekoğlu ◽  
Sevgi ÖZALEVLİ ◽  
Hazal YAKUT ◽  
Rıdvan AKTAN ◽  
Görsev YENER

Abstract Background Like other chronic diseases with limited medical treatment, the most important goal of Alzheimer’s disease rehabilitation is to provide a better quality of life. The purpose of this study was to investigate the factors affecting the quality of life of the patients with Alzheimer's Disease (according to parts of the Quality of Life in Alzheimer’ Disease Questionnaire: patient, proxy and total score). Methods In this cross-sectional study, 73 home-dwelling patients with Alzheimer's Disease and their caregivers were recruited. Cognition, depression and Quality of Life in Alzheimer’ Disease -self rating were asked to the patient. The caregiver was asked about patient’s sociodemographic information, sleepiness, activities of daily living and Quality of Life in Alzheimer’ Disease -proxy rating. Results The Quality of Life in Alzheimer’ Disease -self rating were higher than the Quality of Life in Alzheimer’ Disease -proxy rating. Cognition (p = 0.02), sleepiness (p < 0.01) and depression (p = 0.03) were correlated with the Quality of Life in Alzheimer’ Disease -self rating, while the independence level of the patient in activities of daily living was correlated to the Quality of Life in Alzheimer’ Disease -proxy rating (p < 0.05). Predicting quality of life according to linear regression analysis those were statistically significant in respectively; depression is for Quality of Life in Alzheimer’ Disease, depression and cognition were for Quality of Life in Alzheimer’ Disease -self rating and instrumental activities of daily living was for QoL-AD-PR (p < 0.01). Conclusion While subjective situations such as psychology is important for the patients with Alzheimer's Disease, objective conditions such as the independence of the patient’s in daily life activities are important for the caregiver. While evaluating the quality of life, both the evaluations of the patients with Alzheimer's Disease and the caregiver should be applied, because different things are prioritized by them and priorities of both should be taken into account when planning the treatment program.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ina Shaw ◽  
Melany Cronje ◽  
Brandon Stuwart Shaw

Background: Exercise is related to enhanced cognitive functioning and brain plasticity. Exercise might represent a potential adjunctive treatment for neuropsychiatric disorders, such as Alzheimer's disease (AD). Furthermore, group exercise may prove especially useful due to its additional benefits. Objectives: This study aimed to determine the effect of low-cost, group-based exercise on mental outcomes in patients with mild to moderate AD. Methods: Participants with mild to moderate AD were randomized to either a non-exercising control (CON) group or a group-exercise (GEX) group (n = 20 each). The GEX participated in eight weeks of three-times-weekly non-consecutive 45-minute sessions consisting of balance, resistance, aerobic, and flexibility exercises to determine their effect on mental outcomes, namely, cognitive function, activities of daily living (ADLs), and quality of life (QOL). Results: The intervention program showed a significant (P ≤ 0.05) increase in Mini-Mental State Examination (MMSE) scores (P = 0.023). While the GEX were found to have no change in their (Alzheimer’s disease cooperative study activities of daily living) ADCS-ADL scores (P = 0.574). The CON demonstrated a significant, but deleterious 13.77% decrease in their ADCS-ADL scores from pre- to mid-test (P = 0.023) and from pre- to post-test (P = 0.038). Quality of Life-Alzheimer’s Disease (QOL-AD) scores were unchanged in both the GEX and CON. Conclusions: Our results indicate that a low-cost, multidimensional group exercise intervention can positively influence cognitive function and improve patients with mild to moderate AD ability to perform ADLs.


2002 ◽  
Vol 18 (3) ◽  
pp. 497-507 ◽  
Author(s):  
Andrew Clegg ◽  
Jackie Bryant ◽  
Tricia Nicholson ◽  
Linda McIntyre ◽  
Sofie De Broe ◽  
...  

Objectives: Systematic review of the clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for people suffering from Alzheimer's disease.Methods: Sixteen electronic databases (including MEDLINE, the Cochrane Library, and Embase) and bibliographies of related papers were searched for published/unpublished English language studies, and experts and pharmaceutical companies were consulted for additional information. Randomized controlled trials (RCTs) and economic studies were selected. Clinical effectiveness was assessed on measurement scales assessing progression of Alzheimer's disease on the person's global health, cognition, functional ability, behavior and mood, and quality of life. Cost-effectiveness was presented as incremental cost per year spent in a nonsevere state (by Mini Mental Health State Examination) or quality-adjusted life-year.Results: Twelve of 15 RCTs included were judged to be of good quality. Although donepezil had beneficial effects in Alzheimer's patients on global health and cognition, rivastigmine on global health, and galantamine on global health, cognition, and functional scales, these improvements were small and may not be clinically significant. Measures of quality of life and behavior and mood were rarely assessed. Adverse effects were usually mild and transient. Cost-effectiveness base case estimates ranged from £2,415 savings to £49,476 additional cost (1997 prices) per unit of effect for donepezil and a small savings for rivastigmine. Estimates were not considered robust or generalizable.Conclusions: Donepezil, rivastigmine, and galantamine appear to have some clinical effect for people with Alzheimer's disease, although the extent to which these translate into real differences in everyday life remains unclear. Due to the nature of current economic studies, cost-effectiveness remains uncertain and the impact on different care sectors has been inadequately investigated. Further research is needed to establish the actual benefits of acetylcholinesterase inhibitors (AChEls) for people with Alzheimer's disease and their caregivers, the relationship of these changes to clinical management, and careful prospective evaluation of resource and budgetary consequences.


2014 ◽  
Vol 51 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Denis PAJECKI ◽  
Marco Aurélio SANTO ◽  
Ana Lumi KANAGI ◽  
Daniel RICCIOPPO ◽  
Roberto de CLEVA ◽  
...  

Context Obesity in the elderly is associated with exacerbation of functional decline (dependency), that occurs with aging, because of decreased muscle mass and strength, and increased joint dysfunction. Consequently, there is progressive loss of independence, autonomy, chronic pain and impaired quality of life. The weight loss can bring benefits in all these aspects, especially when accompanied by exercises. Elderly patients with morbid obesity may be submitted to surgical treatment, taking into account that the massive weight loss, eventually caused by bariatric surgery, may exacerbate the loss of muscle mass and nutritional complications that may bring harm to the overall health and quality of life of these patients. The functional assessment of elderly patients, candidates for bariatric surgery and the extent to which surgery can bring benefits to the patients, in the field of functionality, has still to be determined. Objective To describe profile functionality in obese elderly referred to a bariatric surgery program. Methods Patients with age ≥60 and BMI ≥35 underwent comprehensive geriatric assessment that evaluates co morbidities, medication use, ability to perform basic activities of daily living and instrumental activities of daily living, and the “Timedupandgo” test to evaluate mobility, whose cut-off point was ≤10 seconds. Statistical analysis was performed in order to see if there is a positive correlation of dependency with BMI and age (over or under 65 years). Results Forty subjects have completed evaluation. The mean age was 64.1 years (60-72) and 75% were women. They had an average weight of 121.1 kg (72.7-204) and a mean BMI of 47.2 kg/m2 (35.8-68.9). 16 patients (40%) have shown dependency for activities of daily living, 19 (47,5%) for instrumental activities of daily living and 20 patients (50%) had a “Timedupandgo” test over 10 seconds. Statistical analysis (t-Student, Mann-Whitney, Binary Logistic Regression) has shown positive correlation of dependency in activities of daily living for BMI >49 kg/m2, dependency in instrumental activities of daily living for BMI >46,5 kg/m2, and “Timedupandgo” test greater than 10 seconds for BMI >51 kg/m2 (P<0,05). No dependency difference was observed for patients over or under 65 years age. Conclusions Functional decline is observed in almost half of the morbid obese patients over 60 years old. It is related to increasing BMI (BMI >46,5 kg/m2) but not related to age (60 to 65 years or over 65 years). Functional decline should be considered a co-morbidity in the elderly obese patients and should be assessed before bariatric surgery in this population.


Author(s):  
Sara Paiva ◽  
Rui Peleja ◽  
Jorge Cunha ◽  
Carlos Abreu

With increased life expectancy, the incidence of age-related cognitive impairments, faced by the elderly and older generations, is growing. Among the population with cognitive impairments, those that suffer from Alzheimer's disease are the most common. The Alzheimer's disease is a chronic degenerative brain disorder that is characterised by a failure of memory and, in some instances, by disorders in language, perception and planning. As a consequence of the progressive damages imposed by the illness, patients will increasingly seek and need assistance. This paper presents a tool to aid the development and managing of caregiving communities, comprising immediate family members, relatives, neighbours and healthcare professionals, to assist patients with Alzheimer's disease. Such communities could have a strong impact on the quality of care provided to the patients. At the same time, it is hoped that involving communities will significantly improve the quality of life of Alzheimer's patients and their families while reducing the costs related to the care provided.


2017 ◽  
Vol 33 (2) ◽  
pp. e280-e285 ◽  
Author(s):  
Meng Sun ◽  
Brian J. Mainland ◽  
Tisha J. Ornstein ◽  
Sasha Mallya ◽  
Alexandra J. Fiocco ◽  
...  

2013 ◽  
Vol 39 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
Jose Roberto Jardim

OBJECTIVE: To evaluate the impact of asthma on activities of daily living and on health status in patients with controlled, partially controlled, or uncontrolled asthma in Brazil. METHODS: We used data related to 400 patients in four Brazilian cities (São Paulo, Rio de Janeiro, Salvador, and Curitiba), obtained in a survey conducted throughout Latin America in 2011. All study subjects were > 12 years of age and completed a standardized questionnaire in face-to-face interviews. The questions addressed asthma control, hospitalizations, emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. The level of asthma control was determined in accordance with the Global Initiative for Asthma criteria. RESULTS: Among the 400 respondents, asthma was controlled in 37 (9.3%), partially controlled in 226 (56.5%), and uncontrolled in 137 (34.2%). The numbers of patients with uncontrolled or partially controlled asthma who visited the emergency room, who were hospitalized, and who missed school/work were higher than were those of patients with controlled asthma (p = 0.001, p = 0.05, and p = 0.01, respectively). Among those with uncontrolled asthma, the impact of the disease on activities of daily living, sleep, social activities, and normal physical exertion was greater than it was among those with controlled or partially controlled asthma (p < 0.001). CONCLUSIONS: In Brazil, asthma treatment should be monitored more closely in order to increase treatment adherence and, consequently, the level of asthma control, which can improve patient quality of life and minimize the negative impact of the disease.


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