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

Rebecca M. 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 journalArticlepeer-review

1 Scopus citations


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 languageEnglish (US)
Pages (from-to)1387-1396
Number of pages10
JournalJournal of Applied Gerontology
Issue number7
StatePublished - Jul 2023


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

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology


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