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认知障碍和痴呆症老年初级护理患者未满足和已满足护理需求的概况:AgeCoDe和AgeQualiDe研究结果

Profiles of Met and Unmet Care Needs in the Oldest Old Primary Care Patients with Cognitive Disorders and Dementia: Results of the AgeCoDe and AgeQualiDe Study.

作者信息

Kraake Sophia, Pabst Alexander, Bickel Horst, Pentzek Michael, Fuchs Angela, Wiese Birgitt, Oey Anke, König Hans-Helmut, Brettschneider Christian, Scherer Martin, Mallon Tina, Lühmann Dagmar, Maier Wolfgang, Wagner Michael, Heser Kathrin, Weyerer Siegfried, Werle Jochen, Riedel-Heller Steffi G, Stein Janine

机构信息

Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.

Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Dement Geriatr Cogn Disord. 2025;54(2):69-84. doi: 10.1159/000541118. Epub 2024 Aug 29.

Abstract

INTRODUCTION

The prevalence of mild cognitive impairment (MCI) and dementia is increasing as the oldest old population grows, requiring a nuanced understanding of their care needs. Few studies have examined need profiles of oldest old patients with MCI or dementia. Therefore, this study aimed to identify patients' need profiles.

METHODS

The data analysis included cross-sectional baseline data from N = 716 primary care patients without cognitive impairment (n = 575), with MCI (n = 97), and with dementia (n = 44) aged 85+ years from the multicenter cohort AgeQualiDe study "needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+]". Patients' needs were assessed using the Camberwell Assessment of Needs for the Elderly (CANE), and latent class analysis identified need profiles. Multinomial logistic regression analyzed the association of MCI and dementia with need profiles, adjusting for sociodemographic factors, social network (Lubben Social Network Scale [LSNS-6]), and frailty (Canadian Study of Health and Aging-Clinical Frailty Scale [CSHA-CFS]).

RESULTS

Results indicated three profiles: "no needs," "met physical and environmental needs," and "unmet physical and environmental needs." MCI was associated with the met and unmet physical and environmental needs profiles; dementia was associated with the unmet physical and environmental needs profile. Patients without MCI or dementia had larger social networks (LSNS-6). Frailty was associated with dementia.

CONCLUSIONS

Integrated care should address the needs of the oldest old and support social networks for people with MCI or dementia. Assessing frailty can help clinicians to identify the most vulnerable patients and develop beneficial interventions for cognitive disorders.

INTRODUCTION

The prevalence of mild cognitive impairment (MCI) and dementia is increasing as the oldest old population grows, requiring a nuanced understanding of their care needs. Few studies have examined need profiles of oldest old patients with MCI or dementia. Therefore, this study aimed to identify patients' need profiles.

METHODS

The data analysis included cross-sectional baseline data from N = 716 primary care patients without cognitive impairment (n = 575), with MCI (n = 97), and with dementia (n = 44) aged 85+ years from the multicenter cohort AgeQualiDe study "needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+]". Patients' needs were assessed using the Camberwell Assessment of Needs for the Elderly (CANE), and latent class analysis identified need profiles. Multinomial logistic regression analyzed the association of MCI and dementia with need profiles, adjusting for sociodemographic factors, social network (Lubben Social Network Scale [LSNS-6]), and frailty (Canadian Study of Health and Aging-Clinical Frailty Scale [CSHA-CFS]).

RESULTS

Results indicated three profiles: "no needs," "met physical and environmental needs," and "unmet physical and environmental needs." MCI was associated with the met and unmet physical and environmental needs profiles; dementia was associated with the unmet physical and environmental needs profile. Patients without MCI or dementia had larger social networks (LSNS-6). Frailty was associated with dementia.

CONCLUSIONS

Integrated care should address the needs of the oldest old and support social networks for people with MCI or dementia. Assessing frailty can help clinicians to identify the most vulnerable patients and develop beneficial interventions for cognitive disorders.

摘要

引言

随着高龄老年人口的增加,轻度认知障碍(MCI)和痴呆症的患病率也在上升,这就需要对他们的护理需求有细致入微的了解。很少有研究探讨高龄老年MCI或痴呆患者的需求概况。因此,本研究旨在确定患者的需求概况。

方法

数据分析包括来自多中心队列研究“85岁及以上高龄老年初级保健患者的需求、卫生服务利用、成本和健康相关生活质量”(AgeQualiDe研究)的N = 716名初级保健患者的横断面基线数据,这些患者年龄在85岁及以上,其中无认知障碍者(n = 575)、患有MCI者(n = 97)以及患有痴呆症者(n = 44)。使用坎伯韦尔老年需求评估量表(CANE)评估患者的需求,并通过潜在类别分析确定需求概况。多项逻辑回归分析MCI和痴呆症与需求概况之间的关联,并对社会人口学因素、社会网络(鲁本社会网络量表[LSNS - 6])和衰弱(加拿大健康与老龄化研究 - 临床衰弱量表[CSHA - CFS])进行调整。

结果

结果显示出三种概况:“无需求”、“身体和环境需求得到满足”以及“身体和环境需求未得到满足”。MCI与身体和环境需求得到满足以及未得到满足的概况相关;痴呆症与身体和环境需求未得到满足的概况相关。没有MCI或痴呆症的患者拥有更大的社会网络(LSNS - 6)。衰弱与痴呆症相关。

结论

综合护理应满足高龄老年人的需求,并为患有MCI或痴呆症的人提供社会网络支持。评估衰弱有助于临床医生识别最脆弱的患者,并为认知障碍制定有益的干预措施。

引言

随着高龄老年人口的增加,轻度认知障碍(MCI)和痴呆症的患病率也在上升,这就需要对他们的护理需求有细致入微的了解。很少有研究探讨高龄老年MCI或痴呆患者的需求概况。因此,本研究旨在确定患者的需求概况。

方法

数据分析包括来自多中心队列研究“85岁及以上高龄老年初级保健患者的需求、卫生服务利用、成本和健康相关生活质量”(AgeQualiDe研究)的N = 716名初级保健患者的横断面基线数据,这些患者年龄在85岁及以上,其中无认知障碍者(n = 575)、患有MCI者(n = 97)以及患有痴呆症者(n = 44)。使用坎伯韦尔老年需求评估量表(CANE)评估患者的需求,并通过潜在类别分析确定需求概况。多项逻辑回归分析MCI和痴呆症与需求概况之间的关联,并对社会人口学因素、社会网络(鲁本社会网络量表[LSNS - 6])和衰弱(加拿大健康与老龄化研究 - 临床衰弱量表[CSHA - CFS])进行调整。

结果

结果显示出三种概况:“无需求”、“身体和环境需求得到满足”以及“身体和环境需求未得到满足”。MCI与身体和环境需求得到满足以及未得到满足的概况相关;痴呆症与身体和环境需求未得到满足的概况相关。没有MCI或痴呆症的患者拥有更大的社会网络(LSNS - 6)。衰弱与痴呆症相关。

结论

综合护理应满足高龄老年人的需求,并为患有MCI或痴呆症的人提供社会网络支持。评估衰弱有助于临床医生识别最脆弱的患者,并为认知障碍制定有益的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a979/11965832/665fd7295807/dem-2025-0054-0002-541118_F01.jpg

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