The Association of Dementia and Mild Cognitive Impairment With Outpatient Ambulatory Care Utilization in the Community

作者：Yi Chen, Bryan D. James, Ana W. Capuano, Mousumi Banerjee, Mellanie V. Springer, Brittney S. Lange‐Maia, Lisa L. Barnes, David A. Bennett, Julie Bynum, Francine Grodstein · 发表于：Journal of the American Geriatrics Society · 年份：2025 · DOI：10.1111/jgs.19446 · 被引用次数：2 · 研究领域：Dementia and Cognitive Impairment Research、Geriatric Care and Nursing Homes、Pharmaceutical Practices and Patient Outcomes

BACKGROUND: Ambulatory care is critical in delivering interventions for dementia and mild cognitive impairment (MCI), from basic services to novel therapeutics. Yet, little is known regarding how community-dwelling persons with dementia/MCI interact with clinicians in outpatient ambulatory settings. We assessed associations of dementia/MCI with outpatient ambulatory evaluation and management (E&M) visits. METHODS: We included 2116 community-dwelling participants in Rush Alzheimer's Disease Center cohorts, with linked fee-for-service Medicare claims. Annually from 2011 to 2019, cohort neuropsychologic evaluations classified participants as dementia, MCI, or no cognitive impairment (NCI). Across groups, we compared annual probability of visiting providers and number of E&M visits, using repeated measures logistic or generalized Poisson mixed effects models. RESULTS: Across 8672 person-years (PY) of follow-up, the mean age was 82 (SD 7.6) years; 77% of PYs were among females and 24% among Black participants. Controlling for demographics and comorbidity, the annual predicted probability of primary care visits was high in all groups (86%-92%). Although there were few visits with dementia-related specialists, we found a higher probability of these visits among those with dementia (15%) and MCI (17%) than NCI (12%; p = 0.009, dementia vs. NCI; p < 0.001, MCI vs. NCI). There were striking differences in visits to other medical specialties: the mean number of annual visits was 40% low...