Keefer Anne, Dietzel Nikolas, Kolominsky-Rabas Peter L, Graessel Elmar
Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Center for Health Services Research in Medicine, Uniklinikum Erlangen, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
J Alzheimers Dis. 2025 Mar;104(1):73-82. doi: 10.1177/13872877251314060. Epub 2025 Jan 28.
BackgroundLittle is known about the utilization of outpatient support services by people with mild cognitive impairment (MCI).ObjectiveThis study aimed to analyze the use of support services by people with MCI compared to people with mild to moderate dementia.MethodsThe data basis is the multicenter, prospective register study 'Digital Dementia Register Bavaria - digiDEM Bayern'. The sample consists of 913 people with cognitive impairment, including 389 with MCI and 524 with mild to moderate dementia. Classification into 'MCI' and 'mild to moderate dementia' is based on the Mini-Mental State Examination and Montreal Cognitive Assessment. The use of support services was surveyed using the Dementia Assessment of Service Needs. Fisher's exact test and multiple linear regression were conducted to analyze for group differences.ResultsFour out of thirteen support services are used less frequently by people with MCI than by people with mild to moderate dementia: 'Outpatient care' ( < 0.001, φ = -0.199), 'Acquisition of aids' ( = 0.004, φ = -0.096), 'Adult daycare' ( < 0.001, φ = -0.290), and 'Respite care' ( = 0.029, φ = -0.095). Even the overall utilization rate is lower for people with MCI (b = -0.18, = 0.027), although other factors such as a care level (b = 1.01, < 0.001) are more strongly related.ConclusionsThere are differences in utilization between people with MCI and people with mild to moderate dementia, but these are small. Therefore, access to support services should be provided at the first signs of cognitive impairment.
背景
关于轻度认知障碍（MCI）患者对门诊支持服务的利用情况，人们了解甚少。
目的
本研究旨在分析MCI患者与轻度至中度痴呆患者相比对支持服务的使用情况。
方法
数据来源于多中心前瞻性登记研究“巴伐利亚数字痴呆登记册 - digiDEM Bayern”。样本包括913名认知障碍患者，其中389名患有MCI，524名患有轻度至中度痴呆。根据简易精神状态检查表和蒙特利尔认知评估将患者分为“MCI”和“轻度至中度痴呆”两类。使用服务需求痴呆评估来调查支持服务的使用情况。采用费舍尔精确检验和多元线性回归分析组间差异。
结果
在13项支持服务中，有4项服务MCI患者的使用频率低于轻度至中度痴呆患者：“门诊护理”（<0.001，φ = -0.199）、“辅助器具购置”（=0.004，φ = -0.096）、“成人日托”（<0.001，φ = -0.290）和“临时护理”（=0.029，φ = -0.095）。尽管护理水平等其他因素（b = 1.01，<0.001）的相关性更强，但MCI患者的总体利用率仍然较低（b = -0.18，=0.027）。
结论
MCI患者与轻度至中度痴呆患者在服务利用方面存在差异，但差异较小。因此，应在认知障碍的最初迹象出现时就提供支持服务。
