142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Cognitive impairment and multiple chronic conditions: Opportunities for public health research and practice

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:00 PM - 1:15 PM

Lesley Steinman, MSW, MPH , Health Promotion Research Center, University of Washington, Seattle, WA
Background:  The numbers of older adults living with dementia and with multiple chronic conditions is one the rise. There is an urgency to assess what is currently known about dementia and co-occurring chronic conditions regarding both shared risk factors and conditions as well as disease management.

Objectives: To provide a comprehensive picture of chronic conditions among elders living with dementia.

Methods: A systematic literature review and gap analysis, an inventory of existing datasets, and four secondary data analyses using these datasets to address prioritized gaps from the literature review.

Findings: 147 articles met inclusion criteria for the literature review. These articles reported that dementia increased risks of mortality in persons with multiple chronic conditions, was associated with prolonged institutional stays, and decreased function. There was no relationship between dementia and use of cardiovascular or hypertensive medications for persons with those co-occurring conditions. The following gaps were identified and prioritized by a multidisciplinary expert panel: service utilization-hospitalizations, disease-specific outcomes, diabetes, chronic pain, cardiovascular diseases (CVD), depression, falls/fractures, stroke, and multiple chronic conditions. 108 large datasets (N > 500) were identified to support studies of cognitive impairment and comorbid chronic conditions. Four secondary data analyses demonstrate increased depression, CVD, falls, and service utilization for persons with dementia-severity cognitive impairment compared to normal cognitive function.

Implications: This research identified what is currently known about the impact of cognitive impairment on co-occurring chronic conditions, and prioritized gaps and datasets for further study. This work informs priorities for public health research, practice and policymaking.

Learning Areas:

Chronic disease management and prevention
Public health or related research

Learning Objectives:
Describe the current evidence on dementia-severity cognitive impairment and co-occurring chronic conditions. Describe existing datasets with validated data on dementia-severity cognitive impairment and co-occurring chronic conditions. Describe key gaps in the evidence to inform secondary data analyses using these existing datasets. Describe findings from new secondary data analyses to address these gaps. Describe recommendations for public health practice, research and policymakers in this area.

Keyword(s): Dementia, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have coordinated research projects focused on cognitive impairment and co-occurring chronic conditions since 2010. I am particularly interested in understanding these relationships to improve future intervention strategies for the increasing numbers of persons with dementia and multiple chronic conditions..
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.