Primary care service utilisation pattern in dementia: a 10-year longitudinal population-based study.

Background Primary care services play a key role in dementia care, yet activity may vary between subtypes. Objective To investigate longitudinal determinants of primary care contact across Alzheimer's disease (ad), vascular dementia (VD), dementia with Lewy bodies (DLB), and Parkinson's disease deme...

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Publicado en:Age & Ageing Vol. 55; no. 2; pp. 1 - 11
Autores principales: Tjin, Anna, Thang, Leng Leng, Stewart, Robert
Formato: Artículo
Publicado: Oxford University Press / USA Feb2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2026
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      pub: Oxford University Press / USA
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        10.1093/ageing/afag016
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        atl: Primary care service utilisation pattern in dementia: a 10-year longitudinal population-based study.
      aug:
        au:
          Tjin, Anna
          Thang, Leng Leng
          Stewart, Robert
        affil:
          King's College London - Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, Denmark Hill Campus, London, SE5 8AF, United Kingdom of Great Britain and Northern IrelandNational University of Singapore - Department of Japanese Studies, Faculty of Arts and Social Sciences, 10 Kent Ridge Crescent, Singapore 119260, Singapore
          National University of Singapore - Department of Japanese Studies, Faculty of Arts and Social Sciences, 10 Kent Ridge Crescent, Singapore 119260, Singapore
          King's College London - Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, Denmark Hill Campus, London, SE5 8AF, United Kingdom of Great Britain and Northern IrelandSouth London and Maudsley NHS Foundation Trust, London SE5 8AZ, England, United Kingdom of Great Britain and Northern Ireland
      su:
        Primary health care
        Retrospective studies
        Sociodemographic factors
        Parkinson's disease diagnosis
        Alzheimer's disease diagnosis
        Lewy body dementia
        Cognitive testing
        Research funding
        Early medical intervention
        Vascular dementia
        Descriptive statistics
        Longitudinal method
        Medical records
        Acquisition of data
        Data analysis software
        Confidence intervals
        Comparative studies
        Time
      sug:
        subj:
          Primary health care
          Retrospective studies
          Sociodemographic factors
          Parkinson's disease diagnosis
          Alzheimer's disease diagnosis
          Lewy body dementia
          Cognitive testing
          Research funding
          Early medical intervention
          Vascular dementia
          Descriptive statistics
          Longitudinal method
          Medical records
          Acquisition of data
          Data analysis software
          Confidence intervals
          Comparative studies
          Time
      keyword:
        Alzheimer's disease
        comorbidity
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        dementia with Lewy body
        diagnosis
        healthcare service utilisation
        healthcare trajectories
        https://dx.doi.org/10.1093/ageing/afag016
        inLanguage:en
        longitudinal
        older people
        parkinson disease
        Parkinson's disease dementia
        population-based study
        primary care
        primary health care
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41645773/
        vascular dementia
        Alzheimer's disease
        comorbidity
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        dementia with Lewy body
        diagnosis
        healthcare service utilisation
        healthcare trajectories
        https://dx.doi.org/10.1093/ageing/afag016
        inLanguage:en
        longitudinal
        older people
        parkinson disease
        Parkinson's disease dementia
        population-based study
        primary care
        primary health care
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41645773/
        vascular dementia
      ab: Background Primary care services play a key role in dementia care, yet activity may vary between subtypes. Objective To investigate longitudinal determinants of primary care contact across Alzheimer's disease (ad), vascular dementia (VD), dementia with Lewy bodies (DLB), and Parkinson's disease dementia (PDD) 5 years pre-and-post-diagnosis, encompassing clinical, cognitive, functional, and sociodemographic factors. Design Retrospective cohort study. Methods Data on 4384 individuals with first dementia diagnoses (2008–2023) were obtained from a South London catchment linking dementia services with primary care records. Linear mixed-effects models were run on 3-month interval counts (up to 40 intervals per individual, 20 pre-and-post-diagnosis). Separate pre-and-post-diagnosis models assessed longitudinal trends, adjusted for age, sex, and antidepressant use, with subgroup analyses by dementia subtype and cognitive status. Result Service utilisation increased over time, with VD showing a steeper pre-diagnosis rise and PDD moderate post-diagnosis increases compared to ad. Across both periods, worse cognitive impairment and antipsychotic receipt were associated with lower contacts, while older age and Black/British Black ethnicity were associated with higher contact. Pre-diagnosis, agitation, depressed mood, relationship and living conditions problems were linked to lower contact, whereas hallucinations were associated with higher use. Post-diagnosis, hypnotic/anxiolytic use predicted lower contact, while acetylcholinesterase inhibitor receipt, comorbidities, daily living difficulties, and mixed ethnicity were associated with increased utilisation. Conclusion Person-centred care pathways should anticipate subtype-specific and individual patterns, providing targeted support for those with reduced pre-diagnosis contact who may have unmet needs, while considering early intervention for groups anticipated to require increased service use after diagnosis.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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