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Review
. 2017 Dec 28:10:13-28.
doi: 10.2147/CEOR.S146788. eCollection 2018.

Epidemiology, associated burden, and current clinical practice for the diagnosis and management of Alzheimer's disease in Japan

William Montgomery  1 , Kaname Ueda  2 , Margaret Jorgensen  3 , Shari Stathis  3 , Yuanyuan Cheng  3 , Tomomi Nakamura  2
Affiliations
Review

Epidemiology, associated burden, and current clinical practice for the diagnosis and management of Alzheimer's disease in Japan

William Montgomery et al. Clinicoecon Outcomes Res. .

Abstract

The burden of dementia in Japan is large and growing. With the world's fastest aging population, it is estimated that one in five elderly people will be living with dementia in Japan by 2025. The most common form of dementia is Alzheimer's disease (AD), accounting for around two-thirds of dementia cases. A systematic review was conducted to examine the epidemiology and associated burden of AD in Japan and to identify how AD is diagnosed and managed in Japan. English and Japanese language databases were searched for articles published between January 2000 and November 2015. Relevant Japanese sources, clinical practice guideline registers, and reference lists were also searched. Systematic reviews and cohort and case-control studies were eligible for inclusion, with a total of 60 studies included. The most recent national survey conducted in six regions of Japan reported the mean prevalence of dementia in people aged ≥65 years to be 15.75% (95% CI: 12.4, 22.2%), which is much higher than the previous estimated rate of 10% in 2010. AD was confirmed as the predominant type of dementia, accounting for 65.8% of all cases. Advancing age and low education were the most consistently reported risk factors for AD dementia. Japanese guidelines for the management of dementia were released in 2010 providing specific guidance for AD about clinical signs, image findings, biochemical markers, and treatment approaches. Pharmacotherapies and non-pharmacotherapies to relieve cognitive symptoms were introduced, as were recommendations to achieve better patient care. No studies reporting treatment patterns were identified. Due to population aging and growing awareness of AD in Japan, health care expenditure and associated burden are expected to soar. This review highlights the importance of early detection, diagnosis, and treatment of AD as strategies to minimize the impact of AD on society in Japan.

Keywords: dementia; risk factors; systematic review; treatment patterns.

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Conflict of interest statement

Disclosure William Montgomery, Tomomi Nakamura, and Kaname Ueda are all employees at Eli Lilly and Company. Margaret Jorgensen, Shari Stathis, and Yuanyuan Cheng are employed by Health Technology Analysts Pty Ltd, which was commissioned by Eli Lilly and Company to undertake this review of Alzheimer’s disease in Japan. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Selection of studies relating to AD in Japan: (A) epidemiology and (B) treatment patterns and clinical practice guidelines. Abbreviation: AD, Alzheimer’s disease.
Figure 1
Figure 1
Selection of studies relating to AD in Japan: (A) epidemiology and (B) treatment patterns and clinical practice guidelines. Abbreviation: AD, Alzheimer’s disease.
Figure 2
Figure 2
Treatment algorithm for the management of AD in Japan. Notes: A dashed line indicates subsequent progression of the disease; *discontinuation of medication due to “no effect” should be carefully considered. ChEIs included donepezil, galantamine, and rivastigmine. Translated and adapted from Japanese Society of Neurology. Abbreviations: AD, Alzheimer’s disease; ChEIs, cholinesterase inhibitors (donepezil, galantamine, and rivastigmine).
See this image and copyright information in PMC

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