Health Care Services Utilization among Older People with Dementia Comorbidity: A Polytomous Logistic Approach

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  In Refereed Roundtable 100min: Table 05. Healthcare

Abstract

Managing chronic illness presents a profound challenge to many older people. Having to also manage comorbid psychiatric disorders such as dementia, may create gaps between disease prevalence and treatment which contributes to unmet need for care.
This study investigates the health care utilization among Americans 55 years and older with coexisting dementia and one or more chronic medical conditions compared with those with dementia or chronic medical conditions, or neither condition. Multiple polytomous (multinomial) logistic regression was used to analyze a sample (N =7,802) of the 2007 National Health Interview Series, a nationally representative cross-sectional survey.
Multiple polytomous logistic regression shows that when compared to individuals with no diseases, people with either dementia or chronic physical conditions have odds ratio (OR) =3.39; p<0.001 of past year visits to a general provider or mental health professional, relative to no visits. Unexpectedly, those with both dementia and one or more chronic physical conditions had a slightly lower odds ratio (OR) =3.37; p<0.001 of past year visits to a general provider or a mental health professional. When compared to individuals with no diseases, those with either dementia or chronic physical conditions have odds ratio (OR) =3.86; p<0.001 of past year visits to both a general provider and a mental health professional. Whereas, those with both dementia and one or more chronic physical conditions have a much higher odds ratio (OR) =12.22; p<0.001 of past year visits to both a general provider and a mental health professional, relative to no visits.
Managing comorbid dementia presents a profound challenge to older people patients, their family, and to the health profession and system. As the population continue to age, it is imperative to recognize and properly evaluate the care needs and care situation of older patients with dementia and chronic physical conditions.

Author

• Allison Houston, Proscenium Data Solutions