Combinations of Service Use Types of People With Early Cognitive Disorders

J Am Med Dir Assoc. 2016 Jul 1;17(7):620-5. doi: 10.1016/j.jamda.2016.02.034. Epub 2016 Apr 9.


Objectives: Understanding which persons most likely use particular combinations of service types is important as this could lead to a better understanding of care pathways. The aim of this study is to identify combinations of service use within a sample of community-dwelling people with mild cognitive impairment (MCI) and dementia and identify factors related to these service use combinations.

Methods: A latent class analysis performed at baseline on a merged dataset (n = 530) was used to classify care recipients based on following service use types: general practitioner visits, physiotherapist visits, hospital outpatient specialist visits, emergency room visits, hospital inpatient visits with stay over, day care visits, use of domestic homecare, use of personal homecare, and informal care on (instrumental) activities of daily living. Multinomial logistic regression was performed to identify factors associated with service use combinations using clinical characteristics of the care recipient and demographic characteristics of the care recipient and caregiver.

Results: Three service use classes were identified; a formal homecare class (10% of participants), an informal care class (46% of participants), and a low user class (44% of participants). Factors increasing the likelihood of being in the formal homecare class compared with the low service use class included a diagnosis of MCI or dementia, activities of daily living impairment, older age of the care recipient, and care recipient not living together with the caregiver.

Conclusions: Besides a diagnosis of MCI or dementia, other factors (activities of daily living impairment, age, and living situation) were associated with service use. We recommend using these factors alongside the diagnostic label for care indication.

Keywords: Early diagnosis; dementia; latent class analysis; mild cognitive impairment; service use.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction* / therapy
  • Cross-Sectional Studies
  • Female
  • Health Services / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands
  • Young Adult