Applied Economic Department, University of Granada, Campus of Melilla, Melilla, Spain.
Trépel Laboratory, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
J Alzheimers Dis. 2023;95(1):181-193. doi: 10.3233/JAD-230265.
People with high levels of neuroticism are greater users of health services. Similarly, people with dementia have a higher risk of hospitalization and medical visits. As a result, dementia and a high level of neuroticism increase healthcare use (HCU). However, how these joint factors impact the HCU at the population level is unknown. Similarly, no previous study has assessed the degree of generalization of such impacts, considering relevant variables including age, gender, socioeconomic, and country-level variability.
To examine how neuroticism and dementia interact in the HCU.
A cross-sectional study was performed on a sample of 76,561 people (2.4% with dementia) from 27 European countries and Israel. Data were analyzed with six steps multilevel non-binomial regression modeling, a statistical method that accounts for correlation in the data taken within the same participant.
Both dementia (Incidence Rate Ratio (IRR): 1.537; α= 0.000) and neuroticism (IRR: 1.122; α= 0.000) increased the HCU. The effect of having dementia and the level of neuroticism increased the HCU: around 53.67% for the case of having dementia, and 12.05% for each increment in the level of neuroticism. Conversely, high levels of neuroticism in dementia decreased HCU (IRR: 0.962; α= 0.073). These results remained robust when controlling for age, gender, socioeconomic, and country-levels effects.
Contrary to previous findings, neuroticism trait in people with dementia decreases the HCU across sociodemographic, socioeconomic, and country heterogeneity. These results, which take into account this personality trait among people with dementia, are relevant for the planning of health and social services.
神经质水平较高的人会更多地使用卫生服务。同样，痴呆症患者住院和就诊的风险更高。因此，痴呆症和神经质水平升高都会增加医疗保健使用（HCU）。然而，这些共同因素如何在人群层面上影响 HCU 尚不清楚。同样，以前没有研究评估考虑到年龄、性别、社会经济以及国家层面的变异性等相关变量时，这些影响的普遍性程度。
研究神经质和痴呆症如何相互作用影响 HCU。
对来自 27 个欧洲国家和以色列的 76561 人（2.4%患有痴呆症）样本进行了横断面研究。使用六级多水平非二项式回归模型进行数据分析，该统计方法考虑了同一参与者内的数据相关性。
痴呆症（发病率比（IRR）：1.537；α=0.000）和神经质（IRR：1.122；α=0.000）均增加了 HCU。患有痴呆症和神经质水平的影响增加了 HCU：患有痴呆症的情况下约增加 53.67%，神经质水平每增加一个单位则增加 12.05%。相反，痴呆症患者中神经质水平较高会降低 HCU（IRR：0.962；α=0.073）。在控制年龄、性别、社会经济和国家层面的影响后，这些结果仍然稳健。
与之前的发现相反，痴呆症患者的神经质特质会降低 HCU，这种情况存在于社会人口统计学、社会经济和国家异质性中。这些结果考虑了痴呆症患者的这种人格特质，与卫生和社会服务的规划相关。
