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Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life

Published online by Cambridge University Press:  04 September 2020

Erin D. Bouldin Open the ORCID record for Erin D. Bouldin [Opens in a new window] ,
Christopher A. Taylor ,
Kenneth A. Knapp ,
Christina E. Miyawaki ,
Nicholas R. Mercado ,
Karen G. Wooten  and
Lisa C. McGuire
Erin D. Bouldin*
Affiliation:
Alzheimer’s Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
Christopher A. Taylor
Affiliation:
Alzheimer’s Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
Kenneth A. Knapp
Affiliation:
Department of Public Health, New York Medical College, Valhalla, NY, USA
Christina E. Miyawaki
Affiliation:
Graduate College of Social Work, University of Houston, Houston, TX, USA
Nicholas R. Mercado
Affiliation:
Department of Medicine, Donald and Barbara Zucker School of Medicine, Hofstra University/Northwell, Hempstead, NY, USA School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA Division of Medical Ethics, Northwell Health, New York, NY, USA
Karen G. Wooten
Affiliation:
Alzheimer’s Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
Lisa C. McGuire
Affiliation:
Alzheimer’s Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
*
Correspondence should be addressed to: Erin Bouldin, Department of Health and Exercise Science, Appalachian State University, 1179 State Farm Rd, PO Box 32071, Boone, NC28608, USA. Phone: +1 828-262-6892; Fax: +1 828-262-3138. Email: bouldinel@appstate.edu.
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Abstract

Objectives:

To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL).

Design:

Cross-sectional

Setting:

US – 50 states, District of Columbia, and Puerto Rico

Participants:

Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015-–2018 Behavioral Risk Factor Surveillance System reported experiencing SCD and always, usually, or sometimes needed assistance with day-to-day activities because of SCD (n = 6,568).

Measurements:

We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PRs). All estimates were weighted.

Results:

In total, 40.2% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR = 1.55, 95% CI: 1.12–2.13, p = 0.007). Frequent physical distress and social limitations did not differ between people with met and unmet needs.

Conclusions:

Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.

Keywords

subjective health complaintscognitive declinemiddle-agedagedquality of lifecaregiversneedshelping behavior
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 7: Issue Theme: Cognitive Aging: Subjective and Objective , July 2021 , pp. 689 - 702
Copyright
© International Psychogeriatric Association 2020

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