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A comprehensive approach of the determinants of use of care in dementia: the Recaredem (recourse to care in dementia) cross-sectional study

Published online by Cambridge University Press:  30 October 2018

Laetitia Rullier Open the ORCID record for Laetitia Rullier [Opens in a new window] ,
Céline Meillon ,
Valérie Bergua ,
Clément Pimouguet ,
Magali Gonzalez-Colaço Harmand ,
Catherine Helmer ,
Karine Pérès ,
Jean-François Dartigues  and
Hélène Amieva
Laetitia Rullier*
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Céline Meillon
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Valérie Bergua
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Clément Pimouguet
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Magali Gonzalez-Colaço Harmand
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Catherine Helmer
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Karine Pérès
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Jean-François Dartigues
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
Hélène Amieva
Affiliation:
Bordeaux Population Health Research Center, INSERM, University of Bordeaux, Bordeaux, France
*
Correspondence should be addressed to: Laetitia Rullier, Bordeaux Population Health Research Center, INSERM, University of Bordeaux, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France. Phone: 0033 5 57 57 45 38; Fax: 0033 5 57 57 14 86. Email: laetitia.rullier@u-bordeaux.fr.
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Abstract

Background:

Given the rate of the undiagnosed cases of dementia and the consequences of inappropriate care, understanding the factors that explain the use of medical and health care in dementia is a critical concern. Our objective was to identify the psychosocial and medical determinants of use of care in dementia.

Methods:

The study sample consisted of 308 participants: the persons with dementia (n = 99) selected from three French population-based cohorts (i.e. PAQUID, 3C, AMI), their family caregivers (primary, n = 96, and secondary, n = 51), and their general practitioners (n = 62). Use of care in dementia was considered according to two indicators: (1) recourse to secondary care, (2) number of community and health services used.

Results:

Multiple logistic models including sociodemographics and psychosocial variables revealed that the determinants of nonuse of care are similar both for the recourse to secondary care and for the number of community and health services used: lack of education and the contribution of the people with dementia to the decisions regarding their own care and dementia care services in the community area. In addition, satisfaction of the primary caregiver with the services used by his/her relative is associated with non-recourse to secondary care.

Conclusions:

Taken together, these results highlight the predominant role of psychosocial factors in the use of care in dementia and the importance of addressing this issue through an integrative approach including psychological, social, medical, and family dimensions.

Keywords

secondary carecommunity and health servicesdementiapopulation-based studiespatient factorsfamily caregiver factorshealth care-related factors
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 7: Issue Theme: Diverse Approaches to Stemming Cognitive Decline , July 2019 , pp. 1027 - 1037
Copyright
© International Psychogeriatric Association 2018 

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