Alzheimer's & dementia (New York, N. Y.) · 2025
Mental health counseling for caregivers is associated with a slower rate of health-care use in people with dementia.
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Yang Mia, Collier Natasha, Rigdon Joseph, Hugenschmidt Christina E
Аннотация
BACKGROUND: Caregiver support interventions can reduce depression symptoms for caregivers of persons living with cognitive impairment and dementia (PwCI). However, few studies have assessed the effect of caregiver counseling support on the health-care use of the PwCI. The objective of this study was to assess if caregiver participation in mental health counseling can slow health-care use in PwCI.
METHODS: The analysis included all PwCI with cognitive impairment identified through the electronic health records as seen in either the Wake Forest Memory Counseling Program (MCP), providing mental health counseling, and/or the Kulynych Geriatric Consult Clinic (KGCC), providing memory assessment and care, between August 1, 2016, and February 28, 2020. Health-care use (emergency department [ED] use and hospitalization) pre- and post-index date were compared between PwCI who received only medical care (MC) and those who received both medical and mental health care (MC+MHC) using a mixed effects logistic regression model adjusted for age, sex, race, ethnicity, KGCC visit type, and primary diagnosis. Hypothesis testing was accomplished with two-sided Wald tests, and odds ratios (ORs) were used to characterize effect sizes.
RESULTS: Compared to the 1 year pre-index visit, PwCI who received medical care (MC) only experienced an increase in ED visits (OR 1.73, P < 0.0001) and hospitalizations (OR 1.42, P < 0.0001) in the 1 year post-index visit. In contrast, PwCI and caregivers who received medical + mental health care (MC+MHC) did not experience increases in ED visits (OR 1.13, P = 0.5104) or hospitalizations (OR 1.15, P = 0.4849). Compared to MC only, PwCI who received MC+MHC had significantly lower odds of post- versus pre-ED visits (OR 0.65, P = 0.0322) but not hospitalizations (OR 0.81, P = 0.3270).
CONCLUSION: Providing mental health counseling to caregivers in addition to medical care for the PwCI may reduce ED visits among PwCI.
HIGHLIGHTS: This study tests whether caregiver participation in mental health counseling can slow health-care use in the person living with dementia (PLWD).PLWDs who received medical only visits experienced an increase in emergency department (ED) visits compared to those who received both medical and mental health care.Providing mental health counseling to caregivers in addition to medical care for the PLWD may reduce ED visits among PLWD.
METHODS: The analysis included all PwCI with cognitive impairment identified through the electronic health records as seen in either the Wake Forest Memory Counseling Program (MCP), providing mental health counseling, and/or the Kulynych Geriatric Consult Clinic (KGCC), providing memory assessment and care, between August 1, 2016, and February 28, 2020. Health-care use (emergency department [ED] use and hospitalization) pre- and post-index date were compared between PwCI who received only medical care (MC) and those who received both medical and mental health care (MC+MHC) using a mixed effects logistic regression model adjusted for age, sex, race, ethnicity, KGCC visit type, and primary diagnosis. Hypothesis testing was accomplished with two-sided Wald tests, and odds ratios (ORs) were used to characterize effect sizes.
RESULTS: Compared to the 1 year pre-index visit, PwCI who received medical care (MC) only experienced an increase in ED visits (OR 1.73, P < 0.0001) and hospitalizations (OR 1.42, P < 0.0001) in the 1 year post-index visit. In contrast, PwCI and caregivers who received medical + mental health care (MC+MHC) did not experience increases in ED visits (OR 1.13, P = 0.5104) or hospitalizations (OR 1.15, P = 0.4849). Compared to MC only, PwCI who received MC+MHC had significantly lower odds of post- versus pre-ED visits (OR 0.65, P = 0.0322) but not hospitalizations (OR 0.81, P = 0.3270).
CONCLUSION: Providing mental health counseling to caregivers in addition to medical care for the PwCI may reduce ED visits among PwCI.
HIGHLIGHTS: This study tests whether caregiver participation in mental health counseling can slow health-care use in the person living with dementia (PLWD).PLWDs who received medical only visits experienced an increase in emergency department (ED) visits compared to those who received both medical and mental health care.Providing mental health counseling to caregivers in addition to medical care for the PLWD may reduce ED visits among PLWD.