The relationship between frailty, functional dependence, and healthcare needs among community‐dwelling people with moderate to severe dementia
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This paper examines the healthcare needs of community-dwelling older people living in Porto, Portugal, diagnosed with moderate or severe dementia, linked to functional dependency, cognitive decline, limitations in the activities of daily life, and frailty levels. A sample of 83 participants was recruited. Data were collected between 2013 and 2017. A sociodemographic questionnaire, the Clinical Dementia Rating (CDR), the Barthel Index (BI), the Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and the Edmonton Frail Scale (EFS) were used. A set of 26 healthcare needs was defined to support the assessment. The Pearson chi-square or Fisher's exact test (as appropriate) was used to examine the association of the needs (unmet and met) with the levels of dementia and frailty. Participants were diagnosed previously with moderate or severe dementia and benefited from a structured home-care program. There was a high number rated as "severe dementia," "fully dependent," "severely or fully dependent in the activities of daily living (ADL)," and "severe frailty." There were statistically significant differences among needs identified in people with moderate or severe dementia and moderate or severe frailty. The most prevalent healthcare needs in the sample were food preparation, medication/taking pills, looking after their home, toilet use, sensory problems, communication/interaction, bladder, bowels, eating and drinking, memory, sleeping, and falls prevention. In particular, the study identifies a set of needs that are present simultaneously in both frailty and dementia stages. This study underlines that despite well-structured home-care programs for people with dementia, unmet health needs remain. Timely healthcare needs assessment may help professionals to avoid fragmented care and to tailor quality-integrated interventions, including the emotional and psychological balance of the caregiver.
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50.6% of people diagnosed with moderate to severe dementia living in the community were identified as fully dependent with moderate to severe frailty and support needs in many areas.
“For example, one study showed that 50.6% of people diagnosed with moderate to severe dementia living in the community were identified as “fully dependent” with moderate to severe “frailty” and support needs in many areas; food preparation, medication administration, falls prevention and looking after the home [30].”
From Towards defining quality in home care for persons living with dementia (2022) · cites this paper as [30]
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Jacopo, T., Giorgio, D. M., & Michele, M. (2019) · Nursing & Primary Care · doi:10.33425/2639-9474.1116
Self-Reported Needs of People with Dementia Living at Home
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CUIDADOS DOMICILIARIOS PARA PERSONAS MAYORES DEPENDIENTES: UNA REVISIÓN DE ALCANCE
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A retrospective study of factors affecting the severity of dementia in patients
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- Authors
- Abreu, W., Tolson, D., Jackson, G. A., Staines, H., & Costa, N.
- Affiliations
- Centre for Health Technology and Services Research (PT)
- Alzheimer Scotland (GB)
- University of the West of Scotland (GB)
- University of Aveiro (PT)
- Corresponding author
- Abreu, Wilson
- Venue
- Health & Social Care in the Community
- Publisher
- Wiley
- Published
- 2018-11-07
- Volume
- 27
- Issue
- 3
- Pages
- 642-653
- ISSN
- 0966-0410 (ISSN-L)
- 1365-2524
- OpenAlex
- W2889791518
- Cited by
- 43
- References
- 53
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 4 · 2022: 10 · 2021: 7 · 2020: 6 · 2019: 2
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Health & Social Care in the Community (publishedVersion)
- PubMed (publishedVersion)
- The UWS Academic Portal (University of the West of Scotland) (publishedVersion, cc-by-nc-nd)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- dementia, frailty, functional dependence, health care needs, community-dwelling older adults, activities of daily living, instrumental activities of daily living, home care, unmet needs, fall prevention, caregiver burden
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Dementia, Female, Home Care Services, Humans, Male, Middle Aged, Portugal, Severity of Illness Index, Geriatric Assessment, Frail Elderly, Caregivers, Needs Assessment, Independent Living, Cognitive Dysfunction
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