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Reduced Awareness of Memory Deficit is Associated With Increased Medicare Home Health Care Use in Dementia
Journal article   Open access   Peer reviewed

Reduced Awareness of Memory Deficit is Associated With Increased Medicare Home Health Care Use in Dementia

Brittany DeFeis, Silvia Chapman, Carolyn Zhu, Martina Azar, Preeti Sunderaraman, Katherine Ornstein, Yian Gu and Stephanie Cosentino
ALZHEIMER DISEASE & ASSOCIATED DISORDERS, v 33(1), 62
Jan 2019
PMID: 30531365
url
https://europepmc.org/articles/pmc6476304?pdf=renderView

Abstract

Aged Awareness Caregivers - psychology Cross-Sectional Studies Dementia - nursing Female Home Care Services - statistics & numerical data Humans Longitudinal Studies Male Medicare - statistics & numerical data Memory Disorders - psychology Mental Status and Dementia Tests Surveys and Questionnaires United States
The objective of this study was to examine whether reduced awareness of memory deficits in individuals with dementia is associated with more frequent need for Medicare home health care services. Cross-sectional analyses were conducted in a multicenter, clinic-based cohort. In total, 192 participants diagnosed with dementia and their informants were independently asked whether or not the participant demonstrated cognitive symptoms of dementia related to memory and word-finding. Participant self-awareness was measured as the discrepancy between participant and caregiver report of these symptoms. Annual Medicare home health benefit use data was obtained from Medicare claims matched by year to the Predictors study visit. Participants that used home health services had lower awareness scores than those who did not. Awareness remained independently associated with home health use in a logistic regression adjusted for age, gender, education, caregiver relationship, global cognition, dementia subtype, and medical comorbidities. Reduced self-awareness of memory deficits in individuals with dementia is associated with more frequent use of Medicare home health services. The disproportionate use of in-home assistance as a function of awareness level may reflect dangers faced by patients, and challenges faced by caregivers, when patients have limited awareness of their memory deficits. Current results have implications for clinical care, caregiver education, and models of health care utilization.

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9 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Pathology
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