Potentially Unsafe Activities and Living Conditions of Older Adults with Dementia.
Potentially Unsafe Activities and Living Conditions of Older Adults with Dementia.
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DOI：
10.1111/jgs.14164
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发表时间：
2016-06
影响因子：
6.3
通讯作者：
Wolff JL
中科院分区：
文献类型：
--
作者：
Amjad H;Roth DL;Samus QM;Yasar S;Wolff JL
研究在没有报告痴呆症诊断的情况下痴呆症的患病率，以及在全国代表性的老年人样本中，潜在的不安全活动和生活条件是否随痴呆症诊断状态而变化。观察性队列研究。社区7，609名年龄≥ 65岁的医疗保险受益人参加了国家健康和老龄化趋势研究。根据痴呆诊断的自我报告、代理筛选访谈和认知测试，将参与者分为四组：1）报告痴呆诊断的可能痴呆（n=457），2）未报告痴呆诊断的可能痴呆（n=581），3）可能痴呆（n=996）或4）无痴呆（n= 5，575）。我们在分层分析和多变量模型中按痴呆状态亚组检查了潜在的不安全活动（驾驶，准备热餐，管理财务或药物，单独看医生）和生活条件（福尔斯，独居和未满足的需求），调整了社会人口因素，医疗合并症和体能。在可能患有痴呆症的人中，驾驶（22.9%），准备热餐（31%），管理财务（21.9%），管理药物（36.6%）和单独看医生（20.6%）的患病率最低。然而，在可能患有痴呆症的人中，未报告痴呆症诊断的人驾驶，准备热餐，管理财务，管理药物和单独就医的协变量调整率显著高于报告诊断的人（所有比值比≥ 2.00，p < 0.01）。可能患有痴呆症的老年人不知道痴呆症的诊断更有可能报告参与潜在的不安全行为。了解潜在的不安全活动和生活条件的流行程度可以帮助临床医生将安全筛查和咨询集中在诊断或疑似痴呆的老年人身上。
To examine the prevalence of dementia in the absence of a reported dementia diagnosis and whether potentially unsafe activities and living conditions vary as a function of dementia diagnosis status in a nationally representative sample of older adults. Observational cohort study. Community. 7,609 Medicare beneficiaries age ≥ 65 enrolled in the National Health and Aging Trends Study. Participants were classified into four groups based on self-report of dementia diagnosis, proxy screening interview, and cognitive testing: 1) probable dementia with reported dementia diagnosis (n=457), 2) probable dementia without reported dementia diagnosis (n=581), 3) possible dementia (n=996), or 4) no dementia (n=5,575). We examined potentially unsafe activities (driving, preparing hot meals, managing finances or medications, attending doctor visits alone) and living conditions (falls, living alone, and unmet needs) by dementia status subgroups in stratified analyses and multivariate models, adjusting for sociodemographic factors, medical comorbidities, and physical capacity. The prevalence of driving (22.9%), preparing hot meals (31%), managing finances (21.9%), managing medications (36.6%), and attending doctor visits alone (20.6%) was lowest in persons with probable dementia. However, among persons with probable dementia, the covariate-adjusted rates of driving, preparing hot meals, managing finances, managing medications, and attending doctor visits alone were significantly higher in those without reported dementia diagnosis than for those with reported diagnosis (all odds ratios ≥ 2.00, p's < 0.01). Older adults with probable dementia who are not aware of a dementia diagnosis are more likely to report engaging in potentially unsafe behaviors. Understanding the prevalence of potentially unsafe activities and living conditions can help clinicians focus safety screening and counseling in older adults with diagnosed or suspected dementia.