Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T04:10:54.369Z Has data issue: false hasContentIssue false
  • English
  • Français

A comprehensive approach of the determinants of use of care in dementia: the Recaredem (recourse to care in dementia) cross-sectional study

Published online by Cambridge University Press:  30 October 2018

Laetitia Rullier Open the ORCID record for Laetitia Rullier [Opens in a new window] ,
Céline Meillon ,
Valérie Bergua ,
Clément Pimouguet ,
Magali Gonzalez-Colaço Harmand ,
Catherine Helmer ,
Karine Pérès ,
Jean-François Dartigues  and
Hélène Amieva
Laetitia Rullier*
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Céline Meillon
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Valérie Bergua
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Clément Pimouguet
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Magali Gonzalez-Colaço Harmand
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Catherine Helmer
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Karine Pérès
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Jean-François Dartigues
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Hélène Amieva
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
*
Correspondence should be addressed to: Laetitia Rullier, Bordeaux Population Health Research Center, INSERM, University of Bordeaux, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France. Phone: 0033 5 57 57 45 38; Fax: 0033 5 57 57 14 86. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Given the rate of the undiagnosed cases of dementia and the consequences of inappropriate care, understanding the factors that explain the use of medical and health care in dementia is a critical concern. Our objective was to identify the psychosocial and medical determinants of use of care in dementia.

Methods:

The study sample consisted of 308 participants: the persons with dementia (n = 99) selected from three French population-based cohorts (i.e. PAQUID, 3C, AMI), their family caregivers (primary, n = 96, and secondary, n = 51), and their general practitioners (n = 62). Use of care in dementia was considered according to two indicators: (1) recourse to secondary care, (2) number of community and health services used.

Results:

Multiple logistic models including sociodemographics and psychosocial variables revealed that the determinants of nonuse of care are similar both for the recourse to secondary care and for the number of community and health services used: lack of education and the contribution of the people with dementia to the decisions regarding their own care and dementia care services in the community area. In addition, satisfaction of the primary caregiver with the services used by his/her relative is associated with non-recourse to secondary care.

Conclusions:

Taken together, these results highlight the predominant role of psychosocial factors in the use of care in dementia and the importance of addressing this issue through an integrative approach including psychological, social, medical, and family dimensions.

Keywords

secondary carecommunity and health servicesdementiapopulation-based studiespatient factorsfamily caregiver factorshealth care-related factors
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 7: Issue Theme: Diverse Approaches to Stemming Cognitive Decline , July 2019 , pp. 1027 - 1037
Copyright
© International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM IV), 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 36, 1–10. doi: 10.2307/2137284.CrossRefGoogle ScholarPubMed
Bradford, A., Kunik, M. E., Schulz, P., Williams, S. P. and Singh, H. (2009). Missed and delayed diagnosis of dementia in primary care: prevalence and contributing factors. Alzheimer Disease and Associated Disorders, 23, 306–314. doi: 10.1097/WAD.0b013e3181a6bebc.CrossRefGoogle ScholarPubMed
Brayne, C., Fox, C. and Boustani, M. (2007). Dementia screening in primary care: is it time? Journal of American Medical Association, 298, 2409–2411. doi: 10.1001/jama.298.20.2409.CrossRefGoogle ScholarPubMed
Brodaty, H., Thomson, C. and Fine, M. (2005). Why caregivers of people with dementia and memory loss don’t use services. International Journal of Geriatric Psychiatry, 20, 537–546. doi: 10.1002/gps.1322.CrossRefGoogle ScholarPubMed
Bush, C., Kozak, J. and Elmslie, T. (1997). Screening for cognitive impairment in the elderly. Canadian Family Physician, 43, 1763–1768.Google ScholarPubMed
Callahan, C. M., Hendrie, H. C. and Tierney, W. M. (1995). Documentation and evaluation of cognitive impairment in elderly primary care patients. Annals of Internal Medicine, 122, 422–429. doi: 10.7326/0003-4819-122-6-199503150-00004.CrossRefGoogle ScholarPubMed
Cheema, J. R. (2014). Some general guidelines for choosing missing data handling methods in educational research. Journal of Modern Applied Statistical Methods, 13, 53–75. doi: 10.22237/jmasm/1414814520.CrossRefGoogle Scholar
Dartigues, J. F. et al. (1992). The Paquid epidemiological program on brain ageing. Neuroepidemiology, 11, 14–18. doi: 10.1159/000110955.CrossRefGoogle ScholarPubMed
Dichter, M. N., Schwab, C. G., Meyer, G., Bartholomeyczik, S. and Halek, M. (2016). Linguistic validation and reliability properties are weak investigated of most dementia-specific quality of life measurements: a systematic review. Journal of Clinical Epidemiology, 70, 233–245. doi: 10.1016/j.jclinepi.2015.08.002.CrossRefGoogle ScholarPubMed
Fillit, H., Hill, J. W. and Futterman, R. (2002). Health care utilization and costs of Alzheimer’s disease: the role of co-morbid conditions, disease stage, and pharmacotherapy. Family Medicine, 34, 528–535.Google ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi: 10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Helmer, C. et al. (2008). Primary and secondary care consultations in elderly demented individuals in France: results from the Three-City Study. Dementia and Geriatric Cognitive Disorders, 26, 407–415. doi: 10.1159/000164692.CrossRefGoogle ScholarPubMed
Hirschman, K. B., Joyce, C. M., James, B. D., Xie, S. X. and Karlawish, J. H. T. (2005). Do Alzheimer’s disease patients want to participate in a treatment decision, and would their caregivers let them? The Gerontologist, 45, 381–388. doi: 10.1093/geront/45.3.381.CrossRefGoogle Scholar
Hirschman, K. B., Xie, S. X., Feudtner, C. and Karlawish, J. H. T. (2004). How does an Alzheimer’s disease patient’s role in medical decision making change over time? Journal of Geriatric Psychiatry and Neurology, 17, 55–60. doi: 10.1177/0891988704264540.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. Journal of American Medical Association, 185, 914–919. doi: 10.1001/jama.1963.03060120024016.CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. (2000). Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. Journal of Neuropsychiatry and Clinical Neurosciences, 12, 233–239. doi: 10.1176/jnp.12.2.233.CrossRefGoogle ScholarPubMed
Koch, T. and Iliffe, S. (2010). EVIDEM-ED project. Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic review. BMC Family Practice, 11, 52. doi: 10.1186/1471-2296-11-52.CrossRefGoogle ScholarPubMed
Lim, J., Goh, J., Chionh, H. L. and Yap, P. (2012). Why do patients and their families not use services for dementia? Perspectives from a developed Asian country. International Psychogeriatrics, 24, 1571–1580. doi: 10.1017/S1041610212000919.CrossRefGoogle Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer’s disease: patient and caregiver reports. Journal of Mental Health & Aging, 5, 21–32.Google Scholar
Mura, T., Dartigues, J. F. and Berr, C. (2010). How many dementia cases in France and Europe? Alternative projections and scenarios 2010–2050. European Journal of Neurology, 17, 252–259. doi: 10.1111/j.1468-1331.2009.02783.x.CrossRefGoogle ScholarPubMed
Olafsdottir, M., Skoog, I. and Marcusson, J. (2000). Detection of dementia in primary care: the Linkoping study. Dementia and Geriatric Cognitive Disorders, 11, 223–229.CrossRefGoogle ScholarPubMed
Pentzek, M. et al. (2009). General practitioners’ judgment of their elderly patients’ cognitive status. Journal of General Internal Medicine, 24, 1314–1317. doi: 10.1007/s11606-009-1118-2.CrossRefGoogle ScholarPubMed
Perales, J., Cosco, T. D., Stephan, B. C. M., Haro, J. M. and Brayne, C. (2013). Health-related quality-of-life instruments for Alzheimer’s disease and mixed dementia. International Psychogeriatrics, 25, 691–706. doi: 10.1017/S1041610212002293.CrossRefGoogle ScholarPubMed
Pérès, K. et al. (2012). Health and aging in elderly farmers: the AMI cohort. BMC Public Health, 12, 558. doi: 10.1186/1471-2458-12-558.CrossRefGoogle ScholarPubMed
Petrazzuoli, F. et al. (2017). Exploring dementia management attitudes in primary care: a key informant survey to primary care physicians in 25 European countries. International Psychogeriatrics, 29, 1413–1423. doi: 10.1017/S1041610217000552.CrossRefGoogle ScholarPubMed
Pimouguet, C., Bassi, V., Somme, D., Lavallart, B., Helmer, C. and Dartigues, J. F. (2013). The 2008–2012 French Alzheimer plan: a unique opportunity for improving integrated care for dementia. Journal of Alzheimer’s Disease, 34, 307–314. doi: 10.3233/JAD-121648.CrossRefGoogle ScholarPubMed
Pimouguet, C. et al. (2015). Survival and early recourse to care for dementia: a population based study. Alzheimer’s & Dementia, 11, 385–393. doi: 10.1016/j.jalz.2014.04.512.CrossRefGoogle ScholarPubMed
Prince, M., Wimo, A., Guerchet, M., Ali, G. C., Wu, Y. and Prina, A. M. (2015). World Alzheimer Report 2015: The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Costs and Trends. London: Alzheimer’s Disease International.Google Scholar
Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi: 10.1177/014662167700100306.CrossRefGoogle Scholar
Savva, G. M. and Arthur, A. (2015). Who has undiagnosed dementia? A cross-sectional analysis of participants of the Aging, Demographics and Memory Study. Age and Ageing, 44, 642–647.CrossRefGoogle ScholarPubMed
Scalmana, S. et al. (2013). Use of health and social care services in a cohort of Italian dementia patients. Functional Neurology, 28, 265–273.Google Scholar
3C Study Group (2003). Vascular factors and risk of dementia: design of the Three-City Study and baseline characteristics of the study population. Neuroepidemiology, 22, 316–325. doi: 10.1159/000072920.CrossRefGoogle Scholar
Toseland, R. W., McCallion, P., Gerber, T. and Banks, S. (2002). Predictors of health and human services use by persons with dementia and their family caregivers. Social Science & Medicine, 55(7), 1255–1266. doi: 10.1016/S0277-9536(01)00240-4.CrossRefGoogle ScholarPubMed
Zarit, S. H., Orr, N. K. and Zarit, J. M. (1983). Working with Families of Dementia Victims: A Treatment Manual. Washington, DC: Department of Health and Human Services, Administration on Aging.Google Scholar
Supplementary material: File

Rullier et al. supplementary material

Appendix A1

Download Rullier et al. supplementary material(File)
File 19.4 KB