Background
Mild cognitive impairment (MCI), the early stage of dementia, needs adequate intervention for symptom management and improving the patient’s quality of life (QoL). Dementia is a global public health issue that imposes a heavy economic burden worldwide. Dementia is a progressive neurocognitive disease needing assistance with daily activities due to the deterioration of social, intellectual or occupational functions. MCI is an intermediate phase between normal aging and dementia that worsens one or more domains of cognition, including memory, attention, language and executive function. Although, not all patients progress to dementia, about 50% of patients with MCI develop dementia within 3 years and 80% develop within six years. Jujadokseo-hwan (JDH) is a known Korean herbal prescription in Korea and China that improves memory deficit symptoms. Considering the memory-enhancing mechanism of JDH, it has the potential to be assessed as a beneficial treatment for MCI. This study assesses the improvement in quality of life through JDH.
Methods
- This study evaluated the safety and efficacy of JDH for memory deficit (amnesia) in MCI disorders. The total clinical trial period was 24 weeks.
- The clinical data utilized for the economic evaluation were analysed using per-protocol analysis.
- Participants were recruited in a voluntary, competitive enrollment manner in three Korean medicine hospitals.
- Changes in quality of life were measured using the EuroQoL-5 Dimensions (EQ-5D) and Korean version QoL-Alzheimer’s Disease (KQOL-AD).
- Direct medical and non-medical costs were surveyed.
Results
- A total of 64 patients were included in the economic evaluation (n= 35 in JDH, n= 29 in placebo).
- In the JDH group, EQ-5D and KQOL-AD improved by 0.020 (p=.318) and 3.40 (p=.011) over 24 weeks.
- In the placebo group, they increased by 0.001 (p=.920) and 1.07 (p=.130).
- The ICER was KRW (rate of Korean won) 76,400,000 per Quality-adjusted life years and KRW 108,000 per KQOL-AD for JDH, compared to the placebo group.
Conclusion
JDH is not evaluated as a cost-effective treatment option compared with a placebo, nonetheless, it positively impacts the quality of life improvement in patients with mild cognitive impairment.