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. 2021 Jul;33(7):689-702.
doi: 10.1017/S1041610220001635. Epub 2020 Sep 4.

Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life

Erin D Bouldin  1   2 , Christopher A Taylor  1 , Kenneth A Knapp  3 , Christina E Miyawaki  4 , Nicholas R Mercado  5   6   7 , Karen G Wooten  1 , Lisa C McGuire  1
Affiliations

Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life

Erin D Bouldin et al. Int Psychogeriatr. 2021 Jul.

Abstract

Objectives: To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL).

Design: Cross-sectional.

Setting: US - 50 states, District of Columbia, and Puerto Rico.

Participants: Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015--2018 Behavioral Risk Factor Surveillance System reported experiencing SCD and always, usually, or sometimes needed assistance with day-to-day activities because of SCD (n = 6,568).

Measurements: We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PRs). All estimates were weighted.

Results: In total, 40.2% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR = 1.55, 95% CI: 1.12-2.13, p = 0.007). Frequent physical distress and social limitations did not differ between people with met and unmet needs.

Conclusions: Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.

Keywords: aged; caregivers; cognitive decline; helping behavior; middle-aged; needs; quality of life; subjective health complaints.

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Conflict of interest statement

Conflict of Interest

None

Figures

Figure 1.
Figure 1.
Flow diagram for Behavioral Risk Factor Surveillance System respondents age 45 years and older included in the analysis.
See this image and copyright information in PMC

Comment in

References

    1. Al-Sari UA et al. (2017) ‘Do subjective memory complaints predict falls, fractures and healthcare utilization? A two-year prospective study based on a cohort of older women recruited from primary care’, International Journal of Geriatric Psychiatry, 32(9), pp. 968–976. doi: 10.1002/gps.4555. - DOI - PubMed
    1. Alzheimer’s Association (2019) ‘2019 Alzheimer’s Disease Facts and Figures’, Alzheimer’s & Dementia, 15(3), pp. 321–387. doi: 10.1016/j.jalz.2019.01.010. - DOI
    1. Anderson LA et al. (2015) ‘Demographic and health status differences among people aged 45 or older with and without functional difficulties related to increased confusion or memory loss, 2011 Behavioral Risk Factor Surveillance System’, Preventing Chronic Disease, 12, p. E30. doi: 10.5888/pcd12.140429. - DOI - PMC - PubMed
    1. Balash Y et al. (2013) ‘Subjective memory complaints in elders: depression, anxiety, or cognitive decline?’, Acta Neurologica Scandinavica, 127(5), pp. 344–350. doi: 10.1111/ane.12038. - DOI - PubMed
    1. Barros AJD and Hirakata VN (2003) ‘Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio’, BMC medical research methodology, 3, p. 21. doi: 10.1186/1471-2288-3-21. - DOI - PMC - PubMed