Increase in direct social care costs of Alzheimer's disease in Japan depending on dementia severity

Aim: With the aging population, costs of direct social support for patients with Alzheimer's disease have grown and will continue to increase. The purpose of the present study was to estimate the cost of direct social support for Alzheimer's disease under long-term care insurance in Japan. Methods: This cross-sectional study included 169 patients with Alzheimer's disease or mild cognitive impairment who visited a memory clinic and were followed over time. Dementia severity, use of care services and costs were analyzed. Results: The use of direct social support and costs increased significantly between patients with mild, moderate and severe dementia (P ' 0.001). In particular, the use of day services and short stay services increased with the severity of dementia (P ' 0.001). Similar findings were obtained when participants were stratified by long-term care insurance care levels. Of 169 participants, 49 had not applied for long-term care insurance, although their dementia severity was not different from support-need level 1 and care-need level 1. Logistic regression analysis of “did not apply” and “applied and certified” groups showed significant differences not only in dementia severity, but also in age (odds ratio 1.112, 95% confidence interval 1.037–1.193, P = 0.003) and living arrangements (odds ratio 0.257, 95% confidence interval 0.076–0.862, P = 0.028). Conclusions: As the number of patients with Alzheimer's disease increases, direct social costs will increase. The findings of this study might help standardize the type of direct social support provided after diagnosis of Alzheimer's disease and contribute to the development of cost-effective care for these patients. Geriatr Gerontol Int 2019; 19: 1023–1029.