Mia Yang, Natasha Collier, Joseph Rigdon, Christina E. Hugenschmidt
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The objective of this study was to assess if caregiver participation in mental health counseling can slow health-care use in PwCI.</p>\n </section>\n \n <section>\n \n <h3> METHODS</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>Compared to the 1 year pre-index visit, PwCI who received medical care (MC) only experienced an increase in ED visits (OR 1.73, <i>P</i> < 0.0001) and hospitalizations (OR 1.42, <i>P</i> < 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, <i>P</i> = 0.5104) or hospitalizations (OR 1.15, <i>P</i> = 0.4849). Compared to MC only, PwCI who received MC+MHC had significantly lower odds of post- versus pre-ED visits (OR 0.65, <i>P</i> = 0.0322) but not hospitalizations (OR 0.81, <i>P</i> = 0.3270).</p>\n </section>\n \n <section>\n \n <h3> CONCLUSION</h3>\n \n <p>Providing mental health counseling to caregivers in addition to medical care for the PwCI may reduce ED visits among PwCI.</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>This study tests whether caregiver participation in mental health counseling can slow health-care use in the person living with dementia (PLWD).</li>\n \n <li>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.</li>\n \n <li>Providing mental health counseling to caregivers in addition to medical care for the PLWD may reduce ED visits among PLWD.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":53225,"journal":{"name":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","volume":"11 3","pages":""},"PeriodicalIF":6.8000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.70159","citationCount":"0","resultStr":"{\"title\":\"Mental health counseling for caregivers is associated with a slower rate of health-care use in people with dementia\",\"authors\":\"Mia Yang, Natasha Collier, Joseph Rigdon, Christina E. 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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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> RESULTS</h3>\\n \\n <p>Compared to the 1 year pre-index visit, PwCI who received medical care (MC) only experienced an increase in ED visits (OR 1.73, <i>P</i> < 0.0001) and hospitalizations (OR 1.42, <i>P</i> < 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, <i>P</i> = 0.5104) or hospitalizations (OR 1.15, <i>P</i> = 0.4849). 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引用次数: 0
摘要
背景：照顾者支持干预可以减轻认知障碍和痴呆患者（PwCI）照顾者的抑郁症状。然而，很少有研究评估照顾者咨询支持对PwCI保健使用的影响。本研究的目的是评估看护者参与心理健康咨询是否可以减缓PwCI患者的医疗保健使用。方法分析包括2016年8月1日至2020年2月28日期间，通过提供心理健康咨询的Wake Forest记忆咨询项目（MCP）和/或提供记忆评估和护理的Kulynych老年咨询诊所（KGCC）的电子健康记录确定的所有认知障碍PwCI。采用混合效应logistic回归模型，对仅接受医疗护理（MC）和同时接受医疗和精神保健（MC+MHC）的PwCI患者的医疗保健使用（急诊科[ED]使用和住院）前后日期进行比较，该模型调整了年龄、性别、种族、民族、KGCC就诊类型和初步诊断。采用双侧Wald检验完成假设检验，并使用优势比（ORs）来表征效应大小。结果与指数访视前1年相比，接受医疗护理（MC）的PwCI在指数访视后1年的急诊科就诊次数（OR 1.73, P < 0.0001）和住院次数（OR 1.42, P < 0.0001）均有所增加。相比之下，接受医疗+精神卫生保健（MC+MHC）的PwCI和护理人员的ED就诊次数（OR 1.13, P = 0.5104）或住院次数（OR 1.15, P = 0.4849）均未增加。与仅接受MC治疗相比，接受MC+MHC治疗的PwCI患者在ed治疗后与ed治疗前就诊的几率显著降低（OR 0.65, P = 0.0322），但住院率没有显著降低（OR 0.81, P = 0.3270）。结论在护理护理的基础上，对护理人员进行心理健康咨询，可减少重症监护患者的急诊科就诊。本研究测试了照顾者参与心理健康咨询是否可以减缓痴呆症患者的医疗保健使用。与接受医疗和精神卫生保健的患者相比，只接受医疗保健的plwd患者急诊就诊次数增加。除了医疗护理外，向护理人员提供心理健康咨询可能会减少ptsd患者的急诊科就诊。
Mental health counseling for caregivers is associated with a slower rate of health-care use in people with dementia
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.
期刊介绍：
Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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