title: A comprehensive profile of the sociodemographic, psychosocial and health characteristics of Ontario home care clients with dementia.
abstract: BACKGROUND
  This study provides a comprehensive summary of the sociodemographic, psychosocial and health characteristics of a large population-based cohort of Ontario home care clients (aged 50 years and over) with dementia and examines the variation in these characteristics in those with co-existing neurological conditions.
  
  
  METHODS
  Clients were assessed with the Resident Assessment Instrument-Home Care (RAI-HC) between January 2003 and December 2010. Descriptive analyses examined the distribution of these characteristics among clients with dementia relative to several comparison groups, as well as clients with other recorded neurological conditions.
  
  
  RESULTS
  Approximately 22% of clients (n=104 802) had a diagnosis of dementia (average age 83 years, 64% female) and about one in four within this group had a co-existing neurological condition (most commonly stroke or Parkinson disease). About 43% of those with dementia did not live with their primary caregiver. Relative to several comparison groups, clients with dementia showed considerably higher levels of cognitive and functional impairment, aggression, anxiety, wandering, hallucinations/delusions, caregiver distress and a greater risk for institutionalization. Conversely, they showed a lower prevalence of several chronic conditions and lower levels of recent health service use. Depressive symptoms were relatively common in the dementia and other neurological groups.
  
  
  CONCLUSIONS
  Clients with co-existing neurological conditions exhibited unique clinical profiles illustrating the need for tailored and flexible home care services and enhanced caregiver assistance programs.
authors.affiliation: School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Vu
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: D B
authors.initials: DB
authors.lastname: Hogan
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: S B
authors.initials: SB
authors.lastname: Patten
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Jetté
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: S E
authors.initials: SE
authors.lastname: Bronskill
authors.affiliation: School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Heckman
authors.affiliation: Centre de recherche, Institut universitaire de gériatrie de Montréal, Département de médecine, Université de Montréal, Montréal, Quebec, Canada.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kergoat
authors.affiliation: School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: J P
authors.initials: JP
authors.lastname: Hirdes
authors.affiliation: School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.affiliation: School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: M M
authors.initials: MM
authors.lastname: Zehr
authors.affiliation: School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: C J
authors.initials: CJ
authors.lastname: Maxwell
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D001007:Anxiety / Q000150:complications; D017028:Caregivers / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006212:Hallucinations / Q000150:complications; D006304:Health Status; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017533:Marital Status; D008603:Mental Health; D008875:Middle Aged; D009864:Ontario; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D012111:Residence Characteristics; D012737:Sex Factors; D012944:Social Support; D020521:Stroke / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D055816:Wandering Behavior
keywords: Alzheimer disease; dementia; home care; mental health; neurological disorders