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

Rebecca Mullen Lovett; Julia Yoshino Benavente; Lauren A. Opsasnick; Sophia Weiner-Light; Laura M. Curtis; Michael S. Wolf

doi:10.1177/07334648231166289

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

Rebecca Mullen Lovett^*, Julia Yoshino Benavente, Lauren A. Opsasnick, Sophia Weiner-Light, Laura M. Curtis, Michael S. Wolf

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1387-1396
Number of pages	10
Journal	Journal of Applied Gerontology
Volume	42
Issue number	7
DOIs	https://doi.org/10.1177/07334648231166289
State	Published - Jul 2023

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the National Institute of Aging of the National Institutes of Health under award numbers R01AG030611 and P30AG059988. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Lovett reports grants from the NIH (NIA, NINDS), and awards from the Health Assessment Lab. Ms Yoshino Benavente reports grants from the NIH and Gordon and Betty Moore Foundation. Ms Curtis reports grants from the NIH. Dr Wolf reports grants from the NIH (NIA, NIDDK, NINR, NHLBI, NINDS), Gordon and Betty Moore Foundation, and Eli Lilly, and personal fees from Pfizer, Sanofi, Luto UK, GlaxoSmithKline, University of Westminster, and Lundbeck. Ms Opsasnick and Ms Weiner-Light have no conflicts of interest to report.

Keywords

Alzheimer’s disease and related dementias
cognitive impairment
healthcare avoidance
healthcare engagement

ASJC Scopus subject areas

Geriatrics and Gerontology
Gerontology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/07334648231166289

Cite this

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title = "Associations Between Cognitive Impairment Severity and Barriers to Healthcare Engagement Among Older Adults",

abstract = "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.",

keywords = "Alzheimer{\textquoteright}s disease and related dementias, cognitive impairment, healthcare avoidance, healthcare engagement",

author = "Lovett, {Rebecca Mullen} and Benavente, {Julia Yoshino} and Opsasnick, {Lauren A.} and Sophia Weiner-Light and Curtis, {Laura M.} and Wolf, {Michael S.}",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the National Institute of Aging of the National Institutes of Health under award numbers R01AG030611 and P30AG059988. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Lovett reports grants from the NIH (NIA, NINDS), and awards from the Health Assessment Lab. Ms Yoshino Benavente reports grants from the NIH and Gordon and Betty Moore Foundation. Ms Curtis reports grants from the NIH. Dr Wolf reports grants from the NIH (NIA, NIDDK, NINR, NHLBI, NINDS), Gordon and Betty Moore Foundation, and Eli Lilly, and personal fees from Pfizer, Sanofi, Luto UK, GlaxoSmithKline, University of Westminster, and Lundbeck. Ms Opsasnick and Ms Weiner-Light have no conflicts of interest to report. Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

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doi = "10.1177/07334648231166289",

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volume = "42",

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AU - Benavente, Julia Yoshino

AU - Opsasnick, Lauren A.

AU - Weiner-Light, Sophia

AU - Curtis, Laura M.

AU - Wolf, Michael S.

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the National Institute of Aging of the National Institutes of Health under award numbers R01AG030611 and P30AG059988. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Lovett reports grants from the NIH (NIA, NINDS), and awards from the Health Assessment Lab. Ms Yoshino Benavente reports grants from the NIH and Gordon and Betty Moore Foundation. Ms Curtis reports grants from the NIH. Dr Wolf reports grants from the NIH (NIA, NIDDK, NINR, NHLBI, NINDS), Gordon and Betty Moore Foundation, and Eli Lilly, and personal fees from Pfizer, Sanofi, Luto UK, GlaxoSmithKline, University of Westminster, and Lundbeck. Ms Opsasnick and Ms Weiner-Light have no conflicts of interest to report. Publisher Copyright: © The Author(s) 2023.

PY - 2023/7

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N2 - 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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Associations Between Cognitive Impairment Severity and Barriers to Healthcare Engagement Among Older Adults

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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