title: Utilization of healthcare services among elderly with cognitive impairment no dementia and influence of depression and anxiety: a longitudinal study.
abstract: Little objective and nationally representative data are available concerning the influence of cognitive impairment no dementia (CIND) on utilization of healthcare services. The main objective was to compare the use of healthcare services over three years, between elders with current or incident CIND and those without CIND. A second objective was to evaluate the effect of depression and anxiety.
  
  
  
  Cross-sectional and longitudinal data from a population-based survey of 2265 older adults living in Quebec (Canada) were used. CIND was identified using normative data for the Mini-Mental State Examination and was linked with medical records from public health insurance plan. Multinomial logistic regressions adjusted for relevant socio-demographic, social network and health-related confounders were conducted for each service. Interaction between CIND and depression/anxiety was also examined.
  
  
  
  Current CIND was a predictor of longer anxiolytic/sedative/hypnotic medication use. Incident CIND led to longer hospital stay. Depression raised the likelihood of frequenting geriatricians, psychiatrists or neurologists and emergency department, but lessened the likelihood of visiting general practitioners. The addition of the psychiatric conditions to the incident CIND did not increase the likelihood of consuming antidepressants, while the incident CIND cases without psychiatric conditions increased this likelihood.
  
  
  
  Compared to older adults without CIND, older adults with CIND have a distinct utilization of healthcare services. Multiple evaluations over many years may help to better understand the utilization of healthcare services in individuals with CIND. In the meantime, evaluations of these conditions at key moments could allow a more efficient use of health resources.
authors.affiliation: a École de psychologie , Université Laval , Québec , QC , Canada.
authors.forename: Alexandre
authors.initials: A
authors.lastname: St-Hilaire
authors.affiliation: a École de psychologie , Université Laval , Québec , QC , Canada.|b Centre de recherche de l'Institut universitaire en santé mentale de Québec , Québec , QC , Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Hudon
authors.affiliation: c Département des sciences de la santé communautaire , Université de Sherbrooke , Sherbrooke , QC , Canada.|d Centre de recherche Hôpital Charles LeMoyne , Longueuil , QC , Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Préville
authors.affiliation: b Centre de recherche de l'Institut universitaire en santé mentale de Québec , Québec , QC , Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Potvin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000628:therapy*; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011792:Quebec / Q000453:epidemiology
chemical_list: D011619:Psychotropic Drugs
keywords: Mild cognitive impairment; emergency service; hospitalization; primary care; psychotropic drugs