title: Potentially Unsafe Activities and Living Conditions of Older Adults with Dementia.
abstract: To examine the prevalence of dementia in the absence of a reported dementia diagnosis and whether potentially unsafe activities and living conditions vary as a function of dementia diagnosis status in a nationally representative sample of older adults.
  
  
  
  Observational cohort study.
  
  
  
  Community.
  
  
  
  Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study (N = 7,609).
  
  
  
  Participants were classified into four groups based on self-report of dementia diagnosis, proxy screening interview, and cognitive testing: probable dementia with reported dementia diagnosis (n = 457), probable dementia without reported dementia diagnosis (n = 581), possible dementia (n = 996), or no dementia (n = 5,575). Potentially unsafe activities (driving, preparing hot meals, managing finances or medications, attending doctor visits alone) and living conditions (falls, living alone, and unmet needs) were examined according to dementia status subgroups in stratified analyses and multivariate models, adjusting for sociodemographic factors, medical comorbidities, and physical capacity.
  
  
  
  The prevalence of driving (22.9%), preparing hot meals (31.0%), managing finances (21.9%), managing medications (36.6%), and attending doctor visits alone (20.6%) was lowest in persons with probable dementia; however, but in persons with probable dementia, the covariate-adjusted rates of driving, preparing hot meals, managing finances, managing medications, and attending doctor visits alone were significantly higher in those without reported dementia diagnosis than in those with reported diagnosis (all odds ratios ≥2.00, all P < .01).
  
  
  
  Older adults with probable dementia who are not aware of a dementia diagnosis are more likely to report engaging in potentially unsafe behaviors. Understanding the prevalence of potentially unsafe activities and living conditions can help clinicians focus safety screening and counseling in older adults with diagnosed or suspected dementia.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Halima
authors.initials: H
authors.lastname: Amjad
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland.|Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.|Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David L
authors.initials: DL
authors.lastname: Roth
authors.affiliation: Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Quincy M
authors.initials: QM
authors.lastname: Samus
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland.|Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Sevil
authors.initials: S
authors.lastname: Yasar
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland.|Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.|Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wolff
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D006278:Medicare; D015995:Prevalence; D012307:Risk Factors; D012924:Social Conditions; D014481:United States / Q000453:epidemiology
keywords: dementia; observational study; safety