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New Swedish Study Finds People with Alzheimer's who Live Alone Receive Lower Levels of Health care

A new Swedish study, “Living Alone with Alzheimer’s Disease,” published in the Journal of Alzheimer’s Disease (AD), discovered that people with AD who live alone received poorer health care, including a lower standard of AD treatment and diagnosis.

The Study

The study looked at the effect that living alone had on the quality of healthcare.  There were approximately 11,878 participants with AD involved in the study, 46% of whom were found to be living alone at the time of diagnosis.  Most of the study participants living alone were older at diagnosis -88 years old compared to 77 years of age in those who lived with others.  Women were found to comprise 62% of the live alone group. 

In the study, thousands of people diagnosed with AD from 2007 to 2015 were evaluated.  Data came from the Swedish Prescribed Drug Register and the Swedish Patient Register.  Both agencies allowed Karolinska University Hospital’s research scientists to access information, so they could observe how living alone impacted the overall level of health care. Factors such as age, gender, comorbidities and severe dementia were considered separately.

Due to demographics, like an increase in the average person’s lifespan and other factors, such as modern family dynamics, and the increase in the prevalence of age related disorders, the number of AD patients living alone continues to climb.

In general, the number of older adults living alone continues to climb as time goes on.  In fact, the Swedish researchers discovered that the number of seniors aged 60 or older who live in one-person households rose from 23% in 1960 to 32% in 2012.  In this group, women make up the majority of people over 65 who live alone. 

“The high proportion of solitary living, Alzheimer’s disease patients is worrying as this is certainly not a disease patients can deal with alone,” says study author, Pavala Cermakova, in a news release. “We found many inequalities in the health care that is provided.”

Study Outcome

-Those with AD who lived alone were less likely to undergo CT scans, MRI’s or other types of diagnostic testing.

-People with AD living in one person households were less likely to be treated with newer AD medication-such as cholinesterase inhibitors and memantine.

-Elderly folks with AD living on their own were less likely to be given medications for cardiovascular symptoms.

-The group of sole inhabitants were more likely to be taking psychotropic drugs (for depression, anxiety and other mental disorders) such as hypnotics, sedatives and anti-depressants.

One rationale for study findings could include the theory that a caregiver’s presence during the Dr.‘s visit may influence physicians to approach diagnostic testing and treatment differently.  Other factors could be related to a lack of resources for transportation, forgetting appointments more often (without a spouse or roommate to help with reminders) and other factors.

“This study suggests that people who live alone receive less optimal diagnostic work-up and treatment for AD and indicates inequality in the distribution of resources in dementia care due to living conditions,” the researchers concluded.

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