The Aging Brain Care Medical Home: Preliminary Data
The Aging Brain Care Medical Home: Preliminary Data
Between October 1, 2012, and March 31, 2014, 1,650 individuals with dementia, depression, or both were enrolled in the ABC MedHome Registry. Of the 361 discharged from the program over this 18-month period, five refused services, 190 died, six left Eskenazi Health or moved out of the area, 27 entered long-term care, and 37 were found to be in long-term care. As seen in Table 1, the mean age of these individuals was 74.6 ± 8.3, 77.7% were women, and 46.5% were African American. Participants had a high degree of medical comorbidity, with a mean of 3.3 ± 1.8 conditions. Individuals with a dementia diagnosis had a mean Mini-Mental State Examination (MMSE) score of 21.2, and those with dementia and depression diagnoses had a mean MMSE score of 21.7. Participants had a mean of 13 visits, with a mean of 3.2 home visits and 0.5 clinic visits. For participants with dementia and with dementia and depression (for whom these data were recorded), a mean of 1.6 protocols of care were triggered, and a mean of 4.1 care handouts were distributed in each group. In participants with depression (for whom these data were recorded), a mean of 1.6 protocols of care were triggered, and 3.5 care handouts were distributed.
The ABC MedHome was able to reduce dementia and depression symptoms (Table 2). In participants with depression, PHQ-9 scores decreased 1.7 points per year. Of the 59 individuals with ICD-9 codes of depression and an initial PHQ-9 score of 14 or greater, indicating moderately severe depressive symptoms, 66% had at least a 50% reduction in PHQ-9 score within 6 months. In individuals with dementia, HABC-M scores decreased 5.8 points per year. Of the 70 individuals with ICD-9 codes of dementia and a baseline HABC-M score of 14 or greater, indicating high levels of symptoms burden, 51% had at least a 50% reduction in HABC-M score within 6 months.
Results
Between October 1, 2012, and March 31, 2014, 1,650 individuals with dementia, depression, or both were enrolled in the ABC MedHome Registry. Of the 361 discharged from the program over this 18-month period, five refused services, 190 died, six left Eskenazi Health or moved out of the area, 27 entered long-term care, and 37 were found to be in long-term care. As seen in Table 1, the mean age of these individuals was 74.6 ± 8.3, 77.7% were women, and 46.5% were African American. Participants had a high degree of medical comorbidity, with a mean of 3.3 ± 1.8 conditions. Individuals with a dementia diagnosis had a mean Mini-Mental State Examination (MMSE) score of 21.2, and those with dementia and depression diagnoses had a mean MMSE score of 21.7. Participants had a mean of 13 visits, with a mean of 3.2 home visits and 0.5 clinic visits. For participants with dementia and with dementia and depression (for whom these data were recorded), a mean of 1.6 protocols of care were triggered, and a mean of 4.1 care handouts were distributed in each group. In participants with depression (for whom these data were recorded), a mean of 1.6 protocols of care were triggered, and 3.5 care handouts were distributed.
The ABC MedHome was able to reduce dementia and depression symptoms (Table 2). In participants with depression, PHQ-9 scores decreased 1.7 points per year. Of the 59 individuals with ICD-9 codes of depression and an initial PHQ-9 score of 14 or greater, indicating moderately severe depressive symptoms, 66% had at least a 50% reduction in PHQ-9 score within 6 months. In individuals with dementia, HABC-M scores decreased 5.8 points per year. Of the 70 individuals with ICD-9 codes of dementia and a baseline HABC-M score of 14 or greater, indicating high levels of symptoms burden, 51% had at least a 50% reduction in HABC-M score within 6 months.
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