Efficacy of a Dementia-Friendly Integrated Care Network in Mitigating Cognitive Decline and Alleviating Family Care Burden: Insights from the Gan-Dau Healthy Longevity Plan

Abstract

Background/Purpose: The clinical efficacy of community-based dementia-friendly integrated care services has not been well-established in the literature. Therefore, this study aims to assess the potential clinical benefits of these services in terms of enhancing cognitive performance and reducing family care burden. Methods: Participants seeking medical attention for cognitive-related issues or dementia between 2018 and 2022 were included in the study. The investigation was divided into two phases: Phase 1 evaluated the efficacy of the integrated care network in preventing cognitive declines in individuals with mild cognitive impairment, while Phase 2 assessed the temporal evolution of family care burden for participants engaged in the integrated care network. Results: Phase 1 included 298 participants, and those involved in the integrated care network demonstrated significantly higher improvement in Mini-Mental State Examination (MMSE) scores compared to the usual care group. Phase 2, which comprised 235 participants undergoing integrated care, showed a significant increase in family care burden. In Phase 1, those in the dementia-friendly integrated care network showing significantly higher improvement in MMSE scores compared to the usual care group (0.7 ± 1.5 vs. 0.0 ± 2.4, p = 0.011). In the subgroup analysis, oldest old subjects with mild cognitive impairment experienced reduced burden compared to the dementia group (-6.4 ± 12.4 vs. 4.2 ± 10.9, p = 0.036). Phase 2 demonstrated a significant increase in Zarit Burden Interview scores (3.5 ± 11.1, p < 0.001) among participants undergoing integrated care. Conclusion: The study highlights the notable benefits of a community-based dementia-friendly integrated care network in improving cognitive performance and alleviating family care burden, underscoring the significance of this approach in dementia care, while further prospective intervention studies are needed to confirm its clinical benefits for individuals with cognitive impairment or dementia