Care trajectories around a first dementia diagnosis in patients with serious mental illness

Author:

Dufour Isabelle12ORCID,Brodeur Sébastien3,Courteau Josiane4,Roy Marc‐André56,Vanasse Alain47,Quesnel‐Vallee Amélie8910,Vedel Isabelle1112

Affiliation:

1. Nursing School Université de Sherbrooke Sherbrooke Québec Canada

2. Research Center on Aging Université de Sherbrooke Sherbrooke Québec Canada

3. Department of Psychiatry and Neurosciences Université Laval Québec City Québec Canada

4. PRIMUS Research group, CHUS Research center Sherbrooke Québec Canada

5. Department of Psychiatry and Neurosciences Université Laval Québec Québec Canada

6. CERVO Brain Research Group Québec Québec Canada

7. Department of Family and Emergency Medicine Université de Sherbrooke Sherbrooke Québec Canada

8. Department of Sociology, Faculty of Arts McGill University Montreal Québec Canada

9. Department of Epidemiology, Biostatistics, and Occupational Health McGill University Montreal Québec Canada

10. McGill Observatory on Health and Social Services Reforms Montreal Québec Canada

11. Department of Family Medicine, Faculty of Medicine and Health Sciences McGill University Montréal Québec Canada

12. Lady Davis Institute for Medical Research Jewish General Hospital Montréal Québec Canada

Abstract

AimTo develop a typology of care trajectories (CTs) 1 year before and after a first dementia diagnosis in individuals aged ≥65 years, with prevalent schizophrenia or bipolar disorder.MethodsThis was a longitudinal, retrospective cohort study using health administrative data (1996–2016) from Quebec (Canada). We selected patients aged ≥65 years with an incident diagnosis of dementia between 1 January 2014 and 31 December 2016, and a diagnosis of schizophrenia and/or or bipolar disorder. A CT typology was generated by a multidimensional state sequence analysis based on the “6 W” model of CTs. Three dimensions were considered: the care setting (“where”), the reason for consultation (“why”) and the specialty of care providers (“which”).ResultsIn total, 3868 patients were categorized into seven distinct types of CTs, with varying patterns of healthcare use and comorbidities. Healthcare use differed in terms of intensity, but also in its distribution around the diagnosis. For instance, whereas one group showed low healthcare use, healthcare use abruptly increased or decreased after the diagnosis in other groups, or was equally distributed. Other significant differences between CTs included mortality rates and use of long‐term care after the diagnosis. Most patients (67%) received their first dementia diagnosis during hospitalization.ConclusionsOur innovative approach provides a unique insight into the complex healthcare patterns of people living with serious mental illness and dementia, and provides an avenue to support data‐driven decision‐making by highlighting fragility areas in allocating care resources. Geriatr Gerontol Int 2024; 24: 577–586.

Funder

Alzheimer Society Research Program

Publisher

Wiley

Reference55 articles.

1. Insights on multimorbidity and associated health service use and costs from three population-based studies of older adults in Ontario with diabetes, dementia and stroke

2. Continuity of Care and Health Care Utilization in Older Adults With Dementia in Fee-for-Service Medicare

3. Agence de la santé publique du Canada.Dementia in Canada including Alzheimer's disease: highlights from the Canadian chronic disease surveillance system Gouvernement du Canada. p. 62017. Available from:https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/dementia-highlights-canadian-chronic-disease-surveillance/dementia-highlights-canadian-chronic-disease-surveillance.pdf.

4. Effectiveness of multidisciplinary psychiatric home treatment for elderly patients with mental illness: a systematic review of empirical studies

5. World Health Organization.Mental disorders 2022. Available from:https://www.who.int/news-room/fact-sheets/detail/mental-disorders.

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