THE IMPACT OF ALZHEIMER'S DISEASE ON CAREGIVERS IN JAPAN

Saturday, January 9, 2016
Foyer, G/F (Jockey Club School of Public Health and Primary Care Building at Prince of Wales Hospital)

Amir Goren, PhD, Health Outcomes Practice, Kantar Health, New York, NY, William Montgomery, BPharm, Eli Lilly Australia, West Ryde NSW, Australia, Kristin Wrobleski, PhD, Eli Lilly and Company, Indianapolis, IN and Tomomi Nakamura, MD, Eli Lilly Japan K.K., Tokyo, Japan
Purpose: This study aims to describe the impact of caregiving on individuals caring for patients with Alzheimer’s disease (AD) in Japan.

Method(s): Data were from the 2012 National Health and Wellness Survey in Japan (n= 30,000). Caregivers for adult relatives with AD or dementia were compared with non-caregivers on various health outcome measures: Work Productivity and Activity Impairment (WPAI), SF-36v2-based health-related quality of life (HRQoL), and healthcare resource utilization. Sociodemographic characteristics, health characteristics and behaviours, and Charlson comorbidity index (CCI) scores were compared between caregivers and non-caregivers. 

Result(s) : Among 28,416 respondents (714 caregivers; 27,702 non-caregivers),caregivers were older than non-caregivers (52.5 vs 47.3 years respectively), more frequently female (53% vs. 50%), married/partnered (70% vs. 63%), alcohol drinkers (44% vs. 39%), with higher CCI scores (0.4 vs. 0.1, or 20% vs. 11% having CCI ≥ 1), and less likely to be employed (53% vs. 58%), all p<.05.  Adjusting for covariates (age brackets, gender, marital status, CCI, insurance, income, and education), caregivers experienced significantly higher odds of depression (62%, p<.001), anxiety (90%, p=.033), insomnia (60%, p=.001), and pain (52%, p<.001).  Caregivers vs. non-caregivers experienced lower health utilities (-0.031 points, p<.001), and lower HRQoL [PCS (-1.11, p<.001), and MCS (-2.34 points, p<.001)]. Caregivers vs. non-caregivers reported higher rates of work impairment (16% greater, p=.033) among those who were employed, as well as greater activity impairment (23% higher, p<.001).  Caregivers vs. non-caregivers reported higher rates of healthcare provider visits (42% greater, p<.001) and ER visits (140% greater, p=.009), but hospital visits were not significantly greater with caregiving.

Conclusion(s): Those providing care for patients with dementia due to AD in Japan experience a broad range of care-related burden (physical, psychological, social, and financial), with relatively poorer health status and greater comorbid risk, greater productivity impairment, and higher rates of healthcare resource use.