Dataset Information

COVID-19-Related Changes in Assistance Networks for U.S. Older Adults With and Without Dementia.

ABSTRACT:

Objectives

Prepandemic research suggests assistance networks for older adults grow over time and are larger for those living with dementia. We examined how assistance networks of older adults changed in response to the onset of the coronavirus disease 2019 (COVID-19) pandemic and whether these changes differed for those with and without dementia.

Methods

We used 3 rounds of the National Health and Aging Trends Study. We estimated multinomial logistic regression models to test whether changes in assistance networks during COVID-19 (2019-2020)-defined as expansion, contraction, and adaptation-differed from changes prior to COVID-19 (2018-2019). We also estimated ordinary least squares regression models to test differences in the numbers of helpers assisting with one (specialist) versus multiple (generalist) domains before and during COVID-19. For both sets of outcomes, we investigated whether pandemic-related changes differed for those with and without dementia.

Results

Over all activity domains, a greater proportion of assistance networks adapted during COVID-19 compared to the pre-COVID-19 period (relative risk ratio = 1.19, p < .05). Contractions in networks occurred for those without dementia. Transportation assistance contracted for those with and without dementia, and mobility/self-care assistance contracted for those with dementia. The average number of generalist helpers decreased during COVID-19 (β = -0.09, p < .001).

Discussion

Early in the pandemic, assistance networks of older adults adapted by substituting helpers, by contracting to reduce exposures with more intimate tasks for recipients with dementia, and by reducing transportation assistance. Future research should explore the impact of such changes on the well-being of older adults and their assistance networks.

SUBMITTER: Brown MJ

PROVIDER: S-EPMC9384500 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

COVID-19-Related Changes in Assistance Networks for U.S. Older Adults With and Without Dementia.

Brown Monique J MJ Brown Monique J MJ Wang Haowei H Lin I-Fen IF Gan Daniel D Oyeyemi Deborah D Manning Mark M Freedman Vicki A VA

The journals of gerontology. Series B, Psychological sciences and social sciences 20230301 Suppl 1

<h4>Objectives</h4>Prepandemic research suggests assistance networks for older adults grow over time and are larger for those living with dementia. We examined how assistance networks of older adults changed in response to the onset of the coronavirus disease 2019 (COVID-19) pandemic and whether these changes differed for those with and without dementia.<h4>Methods</h4>We used 3 rounds of the National Health and Aging Trends Study. We estimated multinomial logistic regression models to test whet ...[more]

PMID: 35849106

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Project description:BackgroundPain is common among individuals with Alzheimer's disease and related dementias (ADRD), and use of opioids has been increasing over the last decade. Yet, it is unclear to what extent opioids are appropriately prescribed for patients with ADRD and whether the appropriateness of opioid prescribing differs by ADRD status. The objective of this study is to compare the quality of opioid prescribing among patients with or without ADRD who have chronic noncancer pain.MethodsA nationally representative cohort study of Medicare beneficiaries aged 50 years or older who had chronic pain but who had no cancer, hospice, or palliative care from 2011 to 2015. Four indicators of potentially inappropriate opioid prescribing were measured in patients residing in communities (75,258 patients with and 435,870 patients without ADRD); five indicators were assessed in patients in nursing homes (NHs) (37,117 patients with and 5128 patients without ADRD). Each indicator was calculated as the proportion of eligible patients with inappropriate opioid prescribing in the year after a chronic pain diagnosis. Differences in proportions between ADRD and non-ADRD groups were estimated using a generalized linear model adjusting for covariates through inverse probability weighting.ResultsPatients with ADRD versus those without had higher concurrent use of opioids and central nervous system-active drugs (community 44.1% vs 33.3%; NH 58.8% vs 54.1%, both P < 0.001) and no opioids or scheduled pain medications for moderate or severe pain (NH 60.1% vs 52.5%, P < 0.001). The ADRD versus non-ADRD group had higher use of long-term opioids for treating neuropathic pain in communities (21.7% vs 19.5%, P = 0.003) but lower use in NHs (26.9% vs 36.0%, P < 0.001). Use of strong or high-dose opioids when naive to opioids (community 1.5% vs 2.8%; NH 2.5% vs 3.5%) and use of contraindicated opioids (community 0.08% vs 0.12%; NH 0.05% vs 0.21%) were rare for either group.ConclusionPotential inappropriate opioid prescribing in 2 areas of pain care was more common among patients with ADRD than among patients without ADRD in community or NH settings. Further studies aimed at understanding the factors and effects associated with opioid prescribing patterns that deviate from guidelines are warranted.

Dataset Information

COVID-19-Related Changes in Assistance Networks for U.S. Older Adults With and Without Dementia.

Objectives

Methods

Results

Discussion

Publications

COVID-19-Related Changes in Assistance Networks for U.S. Older Adults With and Without Dementia.

Similar Datasets

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