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Publications

Journal Article Ahead of print

PubMed: 42899384 DOI: 10.1097/WAD.0000000000000752

Electronic Dementia Assessment Score: Screenings and Receipt of Home and Community-Based Services.

Alzheimer Dis Assoc Disord

Authors: Rebecca J Howe, Lan Jiang, Matthew D Howe, Zachary J Kunicki, John E McGeary, Mindy M Kibbey, Wen-Chih Wu, Catherine Kelso, Samuel Edwards, James L Rudolph, Jane A Driver

Affiliations

  • VA Providence Healthcare System.
  • Warren Alpert School of Medicine at Brown University, Providence, RI.
  • VA Providence Healthcare System. Warren Alpert School of Medicine at Brown University, Providence, RI.
  • VHA Office of Patient Care Services, Geriatrics and Extended Care, Washington, DC.
  • VA Portland Healthcare System. Oregon Health and Science University, Portland, OR.
  • VA Boston Healthcare System.
  • Harvard Medical School, Boston, MA.

Abstract

INTRODUCTION

With population aging, ensuring that people living with dementia receive appropriate assessment and services is critical. The objective of this study was to determine whether electronic dementia assessment is associated with increased receipt of home-based and community-based services (HCBS) among Veterans with heart failure and newly diagnosed dementia.

METHODS

We conducted a retrospective cohort study of community-dwelling Veterans with heart failure who received an incident dementia diagnosis between 2010 and 2023. Electronic health record (EHR) data were used to identify completion of cognitive, psychiatric, and functional assessments from 365 days before to 90 days after dementia diagnosis. The primary outcome was receipt of HCBS. Logistic regression with inverse probability of treatment weighting adjusted for demographics, comorbidities, and health care utilization.

RESULTS

Among 46,157 Veterans with heart failure and incident dementia, 4% had documented cognitive, 82% psychiatric, and 41% functional assessments. Overall, 25% received HCBS. IPTW-adjusted odds of receiving HCBS significantly increased with electronic health record documentation of cognitive, psychiatric, and functional assessments.

CONCLUSIONS

Among Veterans with heart failure and newly diagnosed dementia, documentation of cognitive, psychiatric, and functional assessments was associated with greater odds of receiving HCBS. Electronic dementia assessment may support system-level efforts to align dementia care with the goals of aging in place.

MeSH

Dementia, Heart Failure, Alzheimer Disease, Heart, Aging, Documentation, Electronic Health Records, Diagnosis, Records