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Clinical characteristics of participants enrolled in an early identification and healthcare management program for dementia based on cluster analysis and the effectiveness of associated support efforts

Published online by Cambridge University Press:  17 February 2020

Hitomi Kawakita ,
Masahiro Ogawa Open the ORCID record for Masahiro Ogawa [Opens in a new window] ,
Keiko Matsumoto ,
Yuichiro Kawakita ,
Mayumi Hara ,
Yumi Koyama ,
Yoshinari Fujita ,
Masanori Oshita ,
Toshio Mori  and
Motomi Toichi
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Hitomi Kawakita
Affiliation:
Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Masahiro Ogawa
Affiliation:
Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Keiko Matsumoto
Affiliation:
The Central Uji Area Comprehensive Support Center, Uji, Kyoto, Japan
Yuichiro Kawakita
Affiliation:
Uji City Welfare Service Public Corporation, Uji, Kyoto, Japan
Mayumi Hara
Affiliation:
Uji City Government Office Health and Welfare Division, Uji, Kyoto, Japan
Yumi Koyama
Affiliation:
Uji City Government Office Health and Welfare Division, Uji, Kyoto, Japan
Yoshinari Fujita
Affiliation:
Uji City Government Office Health and Welfare Division, Uji, Kyoto, Japan
Masanori Oshita
Affiliation:
Uji City Government Office Health and Welfare Division, Uji, Kyoto, Japan
Toshio Mori
Affiliation:
Kyoto Prefectural Rakunan Hospital, Uji, Kyoto, Japan
Motomi Toichi
Affiliation:
Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Hajime Takechi*
Affiliation:
Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
*
Correspondence should be addressed to: Hajime Takechi, Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake city, Aichi, 470-1192, Japan. Phone: + 81 562 932 111; Fax: +81-562-93-9021. Email: takechi@fujita-hu.ac.jp.
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Abstract

Objective:

Although early identification and management services for dementia have become more widespread, their efficacy and the clinical characteristics of service have yet to be fully evaluated. Therefore, the objective of this study is to clarify these issues.

Measurements:

The subjects were 164 Japanese users of an early identification and management program for dementia, known as the Initial-phase Intensive Support Team (IPIST), between 2013 and 2015. Nonhierarchical cluster analysis was used to derive subgroups based on cognitive status and ability in activities of daily living (ADL) and behavioral and psychological symptoms of dementia (BPSD). One-way analysis of variance was performed to evaluate differences among the groups derived by the cluster analysis. A paired t test was used to assess how the clinical status of the groups changed between baseline and follow-up.

Results:

Four groups were identified by cluster analysis, i.e. a mild group, a moderate group, a BPSD group with moderate cognitive impairment and severe BPSD, and a severe group with severe cognitive impairment and severe BPSD. Although there were no significant improvements in cognitive impairment or ADL in any group, significant improvements were found in BPSD in the BPSD and severe BPSD groups. Caregiver burden was significantly lessened in all groups. Clinical diagnosis and long-term care insurance service utilization rates were significantly improved overall.

Conclusion:

The users of IPIST were classified into four subgroups based on their clinical characteristics. The IPIST program could improve the quality of life of people with dementia and their caregivers.

Keywords

Alzheimer’s diseasescaregiver burdencare servicecommunityearly diagnosis
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 5: Issue Theme: Challenges and Facilitators for Diagnosis and Treatment of Dementia , May 2020 , pp. 573 - 583
Copyright
© International Psychogeriatric Association 2020

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