Discontinuity of social support among US adults with cognitive impairment before and after the confirmed diagnosis of dementia: a matched ambidirectional cohort study
Rattachement africain : cn, gb, us, hk. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Despite increased attention on dementia, much remains unknown about the integration of clinical and non-clinical care, particularly regarding long-term social support, a primary source of non-clinical care. This study uniquely examines the effect of receiving a formal dementia diagnosis on the continuity of social support, an understudied transition point in dementia care pathways. METHODS: In this ambidirectional cohort study, we examined ten waves of data from the Health and Retirement Survey(HRS) for US adults over 50 through 2000-2018. Eligibility was limited to participants with cognitive impairment. The exposure group were people with a confirmed dementia diagnosis (N = 1261), and the control group were matched by age, sex, race/ethnicity, and survey wave, but without a confirmed diagnosis (N = 12,604). Unmet social support was defined as reporting physical disability without receiving corresponding social support. Physical disability was assessed using measures of basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). The data were fitted using controlled interrupted time series analysis to explore the continuity of unmet social support before and after a diagnosis. RESULTS: After dementia diagnosis, adults experienced a significant increase in unmet IADL support needs (coef = 0.10, 95% CI [0.07, 0.13]), particularly for making phone calls (coef = 0.74, 95% CI [0.16, 1.33]). By race/ethnicity, Hispanics showed a significant rise in unmet BADL support needs (coef = 0.74, 95% CI [0.03, 1.46]), especially for eating assistance (coef = 1.58, 95% CI [0.17, 2.99]). Blacks experienced increased unmet BADL needs in toileting (coef = 1.52, 95% CI [0.57, 2.47]) and IADL support (coef = 0.09, 95% CI [0.00, 0.17]). Sex disparities were also identified, with females showing decreased unmet BADL support(coef = - 0.55, 95% CI [- 1.03, - 0.06]) but increased unmet IADL support (coef = 0.08, 95% CI [0.04, 0.11]), while males experienced increased unmet toileting (coef = 0.78, 95% CI [0.03, 1.53]) and IADLs support (coef = 0.14, 95% CI [0.10, 0.18]). CONSLUSIONS: Our study identifies a disconnect in the care provided to individuals with dementia before and after their diagnosis. Notably, post-diagnosis, we observed substantial disparities in unmet social support needs across various racial groups. This highlights the need for more cohesive and equitable care strategies in the dementia care continuum.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Discontinuity of social support among US adults with cognitive impairment before and after the confirmed diagnosis of dementia: a matched ambidirectional cohort study
- Date Crossref
- 15/07/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Sun Yat-sen University Clinical Big Data Research Center pays non établi dans la noticeUniversité ou école supérieure
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The Seventh Affiliated Hospital of Sun Yat-sen University pays non établi dans la noticeÉtablissement de santé
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University of Cambridge Department of Psychiatry pays non établi dans la noticeUniversité ou école supérieure
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Cambridgeshire and Peterborough NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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University of Connecticut pays non établi dans la noticeUniversité ou école supérieure
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China Population and Development Research Center pays non établi dans la noticeStructure de recherche
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Chinese University of Hong Kong Department of Medicine and Therapeutics pays non établi dans la noticeUniversité ou école supérieure
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Huazhong University of Science and Technology pays non établi dans la noticeUniversité ou école supérieure
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University of London pays non établi dans la noticeUniversité ou école supérieure
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London School of Hygiene & Tropical Medicine International Centre for Evidence in Disability pays non établi dans la noticeUniversité ou école supérieure
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University of Hong Kong pays non établi dans la noticeUniversité ou école supérieure
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School of Pharmacy pays non établi dans la noticeUniversité ou école supérieure
Clinical Big Data Research Center — Sun Yat-sen University, The Seventh Affiliated Hospital of Sun Yat-sen University et Department of Psychiatry — University of Cambridge, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.