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Unmet needs in community-living persons with dementia are common, often non-medical and related to patient and caregiver characteristics
Open accessAbstract
OBJECTIVE: Understanding which characteristics of persons with dementia (PWD) and their caregivers are associated with unmet needs can inform strategies to address those needs. Our purpose was to determine the percentage of PWD having unmet needs and significant correlates of unmet needs in PWD. DESIGN: Cross-sectional data were analyzed using bivariate and hierarchical multiple linear regression analyses. SETTING: Participants lived in the greater Baltimore, Maryland and Washington DC suburban area. PARTICIPANTS: A sample of 646 community-living PWD and their informal caregivers participated in an in-home assessment of dementia-related needs. MEASUREMENTS: Unmet needs were identified using the Johns Hopkins Dementia Care Needs Assessment. Correlates of unmet needs were determined using demographic, socioeconomic, clinical, functional and quality of life characteristics of the PWD and their caregivers. RESULTS: PWD had a mean of 10.6 (±4.8) unmet needs out of 43 items (24.8%). Unmet needs were most common in Home/Personal Safety (97.4%), General Health Care (83.1%), and Daily Activities (73.2%) domains. Higher unmet needs were significantly related to non-white race, lower education, higher cognitive function, more neuropsychiatric symptoms, lower quality of life in PWD, and having caregivers with lower education or who spent fewer hours/week with the PWD. CONCLUSIONS: Unmet needs are common in community-living PWD, and most are non-medical. Home-based dementia care can identify and address PWD's unmet needs by focusing on care recipients and caregivers to enable PWD to remain safely at home.
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“Neuropsychiatric symptoms likely contribute to increased caregiving demands, making it harder for caregivers to fully address all needs [1].”
From Unmet Needs in Dementia Care: The Predictive Role of Caregiver Challenges (2025) · cites this paper as [1]
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“Individuals with lower education may have less access to health literacy and resources, making it more challenging to navigate care systems, understand their own needs, and advocate for appropriate services [1, 25, 26].”
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“People with dementia (PWD) often experience numerous unmet needs, including difficulties with daily activities, social engagement, emotional well‐being, and access to healthcare [1, 2].”
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McCloskey, R. M., Skerry, L., Keeping‐Burke, L., Donovan, A., Loch Lomond Villa, S. J., Donovan, C., Loch Lomond Villa, S. J., & Scheme, C. (2019) · International Journal of Advanced Nursing Education and Research · doi:10.21742/ijaner.2019.4.3.10 · Cited by 5
Metadata
- Authors
- Black, B. S., Johnston, D., Leoutsakos, J., Reuland, M., Kelly, J., Amjad, H., Davis, K., Willink, A., Sloan, D., Lyketsos, C., & Samus, Q. M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Samus, Quincy M.
- ORCID
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 31
- Issue
- 11
- Pages
- 1643-1654
- ISSN
- 1041-6102 (ISSN-L)
- PMC
- PMC6679825
- OpenAlex
- W2914203969
- Cited by
- 145
- References
- 57
- Citations by year
- 2026: 15 · 2025: 26 · 2024: 25 · 2023: 18 · 2022: 24 · 2021: 19 · 2020: 13 · 2019: 3
- FWCI
- 11.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01 AG046274, 08/15/2014-04/30/2019, NCT02396082)
- Centers for Medicare and Medicaid Services (1C1CMS331332, 09/01/2014-11/30/2017, NCT02395731, = 342)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Keywords
- dementia, unmet needs, informal caregivers, home safety, health care needs, daily activities, neuropsychiatric symptoms, caregiver education, quality of life, cognitive function
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Dementia, Female, Health Services Needs and Demand, Humans, Male, Middle Aged, Quality of Life, Baltimore, Geriatric Assessment, Caregivers, Needs Assessment, Independent Living
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