Unmet care needs and risk profiles of very old people with dementia - a quantitative analysis based on established cohort studies

• Applicant: Dr. Janine Stein
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 502412194

The growing number of the very old population and the associated increasing morbidity, in particular of frequently occurring mental and neurodegenerative diseases in old age, such as dementia and depression, as well as the often simultaneous presence of several diseases (multimorbidity) lead to an increased need for care and high care costs. In the course of these demographic and social developments, a significant increase in the treatment and care needs of older people can be expected over the next few decades. The use of “needs assessments” is essential for the reliable description of the need for care and the appropriateness of the used interventions, in order to comprehensively map the treatment and care needs of patients. The Camberwell Assessment of Need for the Elderly (CANE) was especially developed and used to evaluate the medical and nursing care needs in old age. In particular, the CANE is used for the multidimensional assessment of the physical, psychological and environmental needs of older people. Dementia and depression can be associated with specific unmet care needs, which often remain undetected and untreated, especially in older primary care patients. The reliable recording of unmet needs is very important in order to determine the required level of care and to provide targeted and needs-oriented interventions. So far, mainly the frequencies of unmet needs, especially among older multimorbid patients have been investigated in previous studies. Further analyzes, especially in the case of very old patients with frequent diseases such as dementia and depression, as well as taking into account the perspectives of other raters such as the nursing staff or the general practitioner are still pending. Analyzes of specific risk profiles of unmet needs, taking into account other socio-demographic and clinical factors as well as different rater perspectives, represent a promising approach. Such models would be particularly desirable for very old people and with regard to possible gender differences. The aims of the present application project are cross-sectional and longitudinal analyzes of risk profiles of unmet needs, taking into account further socio-demographic and clinical characteristics based on established cohort studies with older primary care patients (75+ and 85+ years). Thus, the current project wants to close the above mentioned research gaps. The identification of specific risk profiles with an increased probability for certain constellations of unmet needs could represent a decisive starting point for the development and use of tailored interventions and could substantially improve the care of very old patients with dementia and depression as well as their caregivers.

• DFG Programme: Research Grants