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美国患有痴呆症和轻度认知障碍的老年人的社会隔离与医疗保健利用情况

Social Isolation and Healthcare Utilization in Older Adults Living With Dementia and Mild Cognitive Impairment in the United States.

作者信息

Bartley Mairead M, St Sauver Jennifer L, Schroeder Darrell R, Khera Nandita, Griffin Joan M

机构信息

Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota, USA.

Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

Innov Aging. 2024 Sep 10;8(10):igae081. doi: 10.1093/geroni/igae081. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVES

Social isolation is commonly experienced by older people and is associated with adverse health outcomes. Little is known about the influence of social isolation on the risk of acute care utilization among people living with mild cognitive impairment (MCI) or dementia. Our objective was to investigate the impact of social isolation on the risk of death, hospitalization, and emergency department (ED) use among people living with MCI or dementia who are followed in our Community Internal Medicine practice at Mayo Clinic, Rochester, Minnesota.

RESEARCH DESIGN AND METHODS

We included people living with MCI or dementia, 55 years and older, who had a clinic visit between June 1, 2019, and June 30, 2021, and who had completed questions about social connections. The risk of death, hospitalization, and ED use was examined by levels of social connection (socially isolated, moderately isolated, moderately integrated, or socially integrated).

RESULTS

Of 2,320 people included (1,010 with MCI and 1,310 with dementia), 455 (19.6%) were classified as socially isolated and 591 (25.5%) were moderately isolated. Compared with those who were socially integrated, people who were socially isolated were at higher risk of death, hospitalization, and ED visits ( < .001).

DISCUSSION AND IMPLICATIONS

Social isolation is associated with an increased risk of acute health care utilization and death in people living with MCI or dementia. Interventions to address social isolation in this population are needed.

摘要

背景与目的

老年人常经历社会隔离,且这与不良健康后果相关。关于社会隔离对轻度认知障碍(MCI)或痴呆症患者急性护理利用风险的影响,我们知之甚少。我们的目的是调查社会隔离对在明尼苏达州罗切斯特市梅奥诊所社区内科接受随访的MCI或痴呆症患者的死亡、住院和急诊室(ED)使用风险的影响。

研究设计与方法

我们纳入了年龄在55岁及以上、在2019年6月1日至2021年6月30日期间就诊且完成了关于社会关系问题的MCI或痴呆症患者。通过社会关系水平(社会隔离、中度隔离、中度融入或社会融入)来检查死亡、住院和ED使用的风险。

结果

在纳入的2320人中(1010例MCI患者和1310例痴呆症患者),455人(19.6%)被归类为社会隔离,591人(25.5%)为中度隔离。与社会融入者相比,社会隔离者的死亡、住院和急诊就诊风险更高(P<0.001)。

讨论与启示

社会隔离与MCI或痴呆症患者急性医疗利用和死亡风险增加相关。需要采取干预措施来解决该人群的社会隔离问题。

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