Help-seeking for cognitive problems in older adults without dementia: A systematic review

Hill, Nikki L.; Bratlee‐Whitaker, Emily; Sillner, Andrea Yevchak; Brautigam, Leslie

doi:10.1016/j.ijnsa.2021.100050

Cited by 10 publications

(8 citation statements)

References 37 publications

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“…Use of well-established patient-centered communication approaches, such rapport building, actively broaching sensitive topics, empathetic listening, and use of anecdotes, among other techniques, may help to further reduce and address these factors, when present (Storlie, 2015; National Institute on Aging, 2017). Identification and inclusion of care partners in the medical care and decision-making process for those with cognitive impairment is also known to promote greater healthcare engagement (Hill et al, 2021). Increasing uptake and use of reimbursable, person-centered assessment and care planning services, such as Medicare’s Annual Wellness Visit or the recently created CPT ® coding for Cognitive Care Planning, may also help to facilitate symptom reporting among this at-risk population (Alz Assoc, 2016; Ganguli et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…While barriers and facilitators surrounding healthcare engagement specific to ADRD-related concerns or a subjective cognitive complaint have been well-documented in the literature (Hill et al, 2021; Werner et al, 2014), the impact of a cognitive impairment on general, versus disease-specific, aspects of care has not yet been studied. Older adults with a cognitive impairment must often contend with other acute and chronic medical conditions in addition to their cognitive symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Associations Between Cognitive Impairment Severity and Barriers to Healthcare Engagement Among Older Adults

et al. 2023

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Objectives: To assess whether older adults with a cognitive impairment were more likely to report challenges interacting with medical providers, or to avoid needed medical care. Methods: Data for this exploratory, cross-sectional analysis were from older adults ( N = 493) ages 60–82 participating in the “LitCog” cohort study. Multivariable generalized linear models compared cognitive impairment (none, mild, moderate, severe) with validated measures of healthcare engagement. Results: A moderate cognitive impairment was associated with delays in medical care due to embarrassment (RR 5.34.95% CI 1.30–22.0) and discomfort asking the doctor questions (RR 4.07, 95% CI 1.00–16.5). Conclusions: Intermediate cognitive deficits, such as with mild cognitive impairment (MCI) or mild dementias, may impact meaningful engagement with healthcare systems, potentially affecting timely detection and appropriate management of cognitive concerns and other chronic medical conditions. More research is needed to understand mechanisms underlying this relationship.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations Between Cognitive Impairment Severity and Barriers to Healthcare Engagement Among Older Adults

et al. 2023

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“…In addition to health access barriers, there are a variety of personality factors and beliefs spanning social and cultural groups that may largely impact HS in individuals with SCD. 28,44,80 Perceptions of cognitive decline are often accompanied by the feeling of embarrassment, and coping mechanisms targeting the physical and emotional stress associated with SCD, such as social withdrawal and personal isolation, may serve as obstacles to HS. 28,41,[80][81][82] In a study comparing help seekers and non-help seekers with SCD (n = 98, age > 50 y), non-help seekers were more likely to cope by distancing themselves.…”

Section: A Brief Note On Personal Barriers In Relation To Hsmentioning

confidence: 99%

Virtual Assessment as a Way to Reduce Help-seeking Barriers in Older Adults With Subjective Cognitive Decline

Kann,

Zeiger,

Rizer

et al. 2023

Alzheimer Disease &Amp; Associated Disorders

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Subjective cognitive decline (SCD), a potential early marker for neurodegenerative disease such as Alzheimer’s disease, is common among older adults. Although it is often regarded as a personal health concern, most individuals with SCD do not seek help from a health care professional. Help-seeking (HS) is a complex, individualized process with significant life-course implications, and older adults often face several barriers to HS across personal, socioeconomic, and cultural domains. The pandemic exacerbated these barriers by imposing additional limitations on in-person care. In response, virtual assessment became a popular method to conduct remote care. We provide a narrative review of the challenges and triumphs that came with the transition from in-person, pen-paper cognitive assessments to virtual cognitive assessments. In addition, we address the impact virtual assessment had in tackling barriers that previously limited individuals with SCD from formal HS. We argue that virtual cognitive assessment helps alleviate health access barriers to HS (e.g., cost, transportation, and physician availability) and allows individuals with different coping styles to undergo assessment within more convenient environments. We hope the findings presented in this review inform health care practice, public education, and future research targeted towards the use of virtual assessment to facilitate HS in older adults with SCD.

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“…Taken together, this suggests the growing population of older adults living alone are less likely to seek intervention for declining cognitive functions either from a lack of selfawareness due to suboptimal engagement with social support resources such as friends and family [23,24] or from a lack of impetus or desire to seek help such as an early diagnosis [25] even if aware of their condition. Tis implies an increased likelihood that their needs will be overlooked and continue to be unmet, leading to a probable decline in overall well-being.…”

Section: Introductionmentioning

confidence: 99%

Living Alone, Cognitive Function, and Well-Being of Japanese Older Men and Women: A Cross-Sectional Study

Tsuda

Inagaki

Sugiyama

et al. 2023

Health & Social Care in the Community

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This study examined the interaction of living alone and cognitive decline in relation to the well-being of older men and women. We analyzed the data from a cross-sectional, self-administered questionnaire survey of community-dwelling older adults in Tokyo, who were aged 65+ and not on long-term care. The questionnaire included the 10-item self-administered dementia checklist (SDC), the WHO-5 Well-Being Scale, a question on their living arrangement, and participants’ baseline characteristics and social support and social contact. The analyses were stratified by sex and fitted with linear regression models with interaction. A total of 34,255 men and 41,056 women participated. Sample mean age was 73.5 (SD 6.1) for men and 73.6 (SD 6.0) for women, and 18.5% and 26.0% lived alone. The distribution of SDC scores indicated 95.9% and 97.0% had a cognitive status varying from intact to possible mild dementia. Cognitive decline showed a linear association with lower well-being in men (beta −0.53; 95% CI −0.58, −0.48; p < 0.001 ) and women (beta −0.38; 95% CI −0.42, −0.34; p < 0.001 ). Compared to men and women living with others, those living alone experienced lower well-being as their cognitive function declined, and the interactions (living arrangements ∗ SDC) were statistically significant. After controlling participants’ characteristics and social support and social contact, the interaction was significant in men ( p < 0.001 ) but not in women ( p = 0.46 ). Our findings support that older men and women living alone experience a slightly steeper downward trajectory of cognitive decline and poor well-being than their counterparts living with others. The unequivocal effects of controlling confounding factors between men and women indicate the need for gendered countermeasures by welfare services.

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Help-seeking for cognitive problems in older adults without dementia: A systematic review

Cited by 10 publications

References 37 publications

Associations Between Cognitive Impairment Severity and Barriers to Healthcare Engagement Among Older Adults

Associations Between Cognitive Impairment Severity and Barriers to Healthcare Engagement Among Older Adults

Virtual Assessment as a Way to Reduce Help-seeking Barriers in Older Adults With Subjective Cognitive Decline

Living Alone, Cognitive Function, and Well-Being of Japanese Older Men and Women: A Cross-Sectional Study

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