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Association between experiencing low healthcare quality and developing dementia
Indexado
WoS WOS:001176327700001
Scopus SCOPUS_ID:85186576892
DOI 10.1111/JGS.18842
Año 2024
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Background: Low healthcare quality has been found to predict the development of a number of illnesses in older adults. However, it has not been investigated as a determinant of dementia. Thus, the goal of this study was to assess whether experiencing low healthcare quality is associated with developing dementia in people aged 60 and older. Methods: Participants in the Health and Retirement Study, without dementia and aged 60 and older at baseline, were followed from 2006 to 2019. Experiencing low healthcare quality was assessed at baseline through questions about healthcare discrimination and dissatisfaction with healthcare services. The outcome, development of new cases of dementia, was determined through physician diagnosis or a cognition score compatible with dementia (assessed by the Telephone Interview for Cognitive Status). Cox regression was used to estimate the hazard ratio (HR) of dementia, adjusting for participants' demographic, health, and socioeconomic factors. Results: Among the 3795 participants included in the cohort, 700 developed dementia. Experiencing low healthcare quality was associated with increased dementia risk over 12 years (unadjusted HR: 1.68, 95% CI: 1.27-2.21, p-value <0.001; fully adjusted HR: 1.50, 95% CI: 1.12-2.01, p-value: 0.006). Healthcare discrimination and dissatisfaction with the healthcare quality received were independently associated with increased dementia risk. Conclusions: As predicted, experiencing low healthcare quality was associated with greater dementia risk. To date, most measures to reduce dementia have focused on individual-level behaviors. Our findings suggest that implementing structural changes to improve healthcare quality delivery for older persons could reduce dementia prevalence.

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Disciplinas de Investigación



WOS
Geriatrics & Gerontology
Gerontology
Scopus
Geriatrics And Gerontology
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Aravena, Jose M. - YALE UNIV - Estados Unidos
Universidad Central de Chile - Chile
Yale University - Estados Unidos
2 Chen, Xi - YALE UNIV - Estados Unidos
Yale University - Estados Unidos
3 Levy, Becca R. - YALE UNIV - Estados Unidos
Yale University - Estados Unidos

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Financiamiento



Fuente
National Institute on Aging
Agencia Nacional de Investigación y Desarrollo
National Research and Development Agency of Chile
Whitney and Betty MacMillan Center for International and Area Studies
Yale Social and Behavioral Sciences Research Fund
Yale University Council
Health and Retirement Study

Muestra la fuente de financiamiento declarada en la publicación.

Agradecimientos



Agradecimiento
The corresponding author has listed everyone who contributed significantly to the work.
This work was supported by the National Institute on Aging provided funding for the Health and Retirement Study (U01AG009740). Aravena was supported by a Fulbright Fellowship, a National Research and Development Agency of Chile (ANID) Fellowship, the Yale Social and Behavioral Sciences Research Fund, and grants from the Yale University Council on Latin American and Iberian Studies, and the Yale MacMillan Center for International and Area Studies. Chen was supported by the National Institute on Aging grants R01AG077529 and P30AG021342. Levy was supported by the National Institute on Aging grants R01AG067533 and U01AG032284.

Muestra la fuente de financiamiento declarada en la publicación.