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Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project
BACKGROUND: We previously demonstrated a positive correlation with nursing home (NH) replacement and donepezil (DNP) administration on lifetime expectancy after the onset of Alzheimer’s disease (AD). However, the correlation with quality-adjusted life-year (QALY) remains to be elucidated, along with...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635582/ https://www.ncbi.nlm.nih.gov/pubmed/26542372 http://dx.doi.org/10.1186/s12883-015-0475-1 |
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author | Meguro, Kenichi Akanuma, Kyoko Meguro, Mitsue Kasai, Mari Ishii, Hiroshi Yamaguchi, Satoshi |
author_facet | Meguro, Kenichi Akanuma, Kyoko Meguro, Mitsue Kasai, Mari Ishii, Hiroshi Yamaguchi, Satoshi |
author_sort | Meguro, Kenichi |
collection | PubMed |
description | BACKGROUND: We previously demonstrated a positive correlation with nursing home (NH) replacement and donepezil (DNP) administration on lifetime expectancy after the onset of Alzheimer’s disease (AD). However, the correlation with quality-adjusted life-year (QALY) remains to be elucidated, along with the additional impact of concomitant cerebrovascular disease (CVD). Based upon our recently reported health state utility values, we retrospectively analyzed the correlation with NH replacement and/or DNP administration on QALY and life expectancy in ‘pure’ AD (without CVD) and AD with CVD patients. METHODS: All outpatients at the Tajiri Clinic from 1999–2012 with available medical records and death certificates were included. The entry criteria were a dementia diagnosis (DSM-IV) and diagnoses of pure AD or AD with CVD (NINCDS-ADRDA), medical treatment for more than 3 months, and follow up to less than 1 year before death. The main outcomes were lifetime expectancy (months between the onset of dementia and death) and QALY. RESULTS: We identified 390 subjects, of whom 275 had the diagnosis of dementia that met the entry criteria, including 67 pure AD, 33 AD with CVD, and 110 VaD patients. For the AD patients, 52 had taken DNP and 48 had not received the drug due to treatment prior to the introduction of DNP in 1999 in Japan. For the pure AD group, there were positive correlation between NH and DNP and QALY, as well as lifetime expectancy. As for the AD with CVD group, only a correlation between DNP and lifetime expectancy was noted, with no correlation with QALY. CONCLUSIONS: We found positive correlations between DNP administration and NH replacement and lifetime expectancy and QALY after the onset of AD. However, concomitant CVD negated such a positive correlation with QALY. The findings suggest that QALY in AD is affected by CVD; thus, indicating the importance of CVD prevention. |
format | Online Article Text |
id | pubmed-4635582 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-46355822015-11-07 Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project Meguro, Kenichi Akanuma, Kyoko Meguro, Mitsue Kasai, Mari Ishii, Hiroshi Yamaguchi, Satoshi BMC Neurol Research Article BACKGROUND: We previously demonstrated a positive correlation with nursing home (NH) replacement and donepezil (DNP) administration on lifetime expectancy after the onset of Alzheimer’s disease (AD). However, the correlation with quality-adjusted life-year (QALY) remains to be elucidated, along with the additional impact of concomitant cerebrovascular disease (CVD). Based upon our recently reported health state utility values, we retrospectively analyzed the correlation with NH replacement and/or DNP administration on QALY and life expectancy in ‘pure’ AD (without CVD) and AD with CVD patients. METHODS: All outpatients at the Tajiri Clinic from 1999–2012 with available medical records and death certificates were included. The entry criteria were a dementia diagnosis (DSM-IV) and diagnoses of pure AD or AD with CVD (NINCDS-ADRDA), medical treatment for more than 3 months, and follow up to less than 1 year before death. The main outcomes were lifetime expectancy (months between the onset of dementia and death) and QALY. RESULTS: We identified 390 subjects, of whom 275 had the diagnosis of dementia that met the entry criteria, including 67 pure AD, 33 AD with CVD, and 110 VaD patients. For the AD patients, 52 had taken DNP and 48 had not received the drug due to treatment prior to the introduction of DNP in 1999 in Japan. For the pure AD group, there were positive correlation between NH and DNP and QALY, as well as lifetime expectancy. As for the AD with CVD group, only a correlation between DNP and lifetime expectancy was noted, with no correlation with QALY. CONCLUSIONS: We found positive correlations between DNP administration and NH replacement and lifetime expectancy and QALY after the onset of AD. However, concomitant CVD negated such a positive correlation with QALY. The findings suggest that QALY in AD is affected by CVD; thus, indicating the importance of CVD prevention. BioMed Central 2015-11-05 /pmc/articles/PMC4635582/ /pubmed/26542372 http://dx.doi.org/10.1186/s12883-015-0475-1 Text en © Meguro et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Meguro, Kenichi Akanuma, Kyoko Meguro, Mitsue Kasai, Mari Ishii, Hiroshi Yamaguchi, Satoshi Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project |
title | Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project |
title_full | Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project |
title_fullStr | Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project |
title_full_unstemmed | Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project |
title_short | Lifetime expectancy and quality-adjusted life-year in Alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the Tajiri Project |
title_sort | lifetime expectancy and quality-adjusted life-year in alzheimer’s disease with and without cerebrovascular disease: effects of nursing home replacement and donepezil administration – a retrospective analysis in the tajiri project |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635582/ https://www.ncbi.nlm.nih.gov/pubmed/26542372 http://dx.doi.org/10.1186/s12883-015-0475-1 |
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