Rosenwohl-Mack Amy, Dubbin Leslie, Chodos Anna, Dulaney Sarah, Fang Min-Lin, Merrilees Jennifer, Portacolone Elena
Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, USA.
Division of Geriatrics, University of California San Francisco, USA.
Innov Aging. 2021 Jan 18;5(1):igab004. doi: 10.1093/geroni/igab004. eCollection 2021.
Formal supports and social services are essential to people living alone with cognitive impairment (PLACI) because they are at risk of negative health outcomes and lack cohabitants who may support them with cognitively demanding tasks. To further our understanding of this critical and worldwide issue, we conducted a systematic review to understand whether, and how, PLACI access and use essential formal supports and services.
We searched 6 databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, and Sociological Abstracts) to identify quantitative and mixed-method literature on formal service use among PLACI. The initial search was conducted in 2018 and updated in 2020.
We identified 32 studies published between 1992 and 2019, representing 13 countries, that met our criteria: 16 reported on health services and 26 on social services. Most studies compared PLACI with people with cognitive impairment living with others. Health service use was lower or similar among PLACI, as opposed to counterparts living with others. Most studies reported a higher use of social services (e.g., home services) among PLACI than those living with others. Overall use of essential home service among PLACI was higher in Europe than in the United States, a country where large portions of PLACI were reported receiving no formal services.
We identified wide variability among countries and major gaps in service use. Results for use of health services were mixed, although our findings suggest that PLACI may have fewer physician visits than counterparts living with others. Our findings suggest that varying policies and budgets for these services among countries may have affected our findings. We encourage researchers to evaluate and compare the influence of social policies in the well-being of PLACI. We also encourage policy makers to prioritize the needs of PLACI in national dementia strategies.
正式支持和社会服务对于认知障碍独居者（PLACI）至关重要，因为他们面临负面健康结果的风险，且缺乏能够协助他们完成认知要求较高任务的同居者。为了进一步了解这一关键且全球性的问题，我们进行了一项系统综述，以了解PLACI是否以及如何获取和使用基本的正式支持与服务。
我们检索了6个数据库（PubMed、Embase、PsycINFO、CINAHL、科学引文索引和社会学文摘），以识别关于PLACI使用正式服务的定量和混合方法文献。初始检索于2018年进行，并于2020年更新。
我们确定了1992年至2019年间发表的32项研究，涵盖13个国家，符合我们的标准：16项报告了健康服务，26项报告了社会服务。大多数研究将PLACI与认知障碍的非独居者进行了比较。与非独居的同龄人相比，PLACI的健康服务使用率较低或相似。大多数研究报告称，PLACI比非独居者更多地使用社会服务（如家庭服务）。欧洲PLACI的基本家庭服务总体使用率高于美国，在美国，有很大一部分PLACI报告未接受任何正式服务。
我们发现各国之间存在很大差异，服务使用方面存在重大差距。健康服务使用情况的结果不一，尽管我们的研究结果表明，PLACI看医生的次数可能比非独居的同龄人少。我们的研究结果表明，各国这些服务的政策和预算不同可能影响了我们的研究结果。我们鼓励研究人员评估和比较社会政策对PLACI福祉的影响。我们还鼓励政策制定者在国家痴呆症战略中优先考虑PLACI的需求。
