Abstract Details

Title Frequency of Quality Care in Dementia With Lewy Bodies in Cohorts With and Without Specialty Care

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-012

Objective To investigate the frequency of quality care in moderate-advanced dementia with Lewy bodies (DLB), including in individuals with and without specialty care.

Background DLB is a common degenerative dementia, however the frequency of high-quality care is unknown.

Design/Methods Dyads of moderate-advanced DLB patients and their caregivers were recruited from DLB Centers of Excellence, advocacy organizations, or research registries. Caregivers completed questionnaires regarding demographics, healthcare, and ancillary referrals. Descriptive statistics report the frequency of care aligning with dementia and parkinsonism quality measures. Secondary analyses compared specialty and non-specialty care via chi-square and t-tests. P-values were adjusted for multiple testing.

Results Of 189 dyads, patients were on average 75+8 years-old (77.8% male, 95.2% White, average time since diagnosis 3.2 + 3.1 years). Forty percent of participants reported care from a movement or dementia specialist, 34% from a DLB specialist, and 51% from general neurology. 132 (69.8%) patients were taking a cholinesterase inhibitor. The average Anticholinergic Burden (ACB) score was 2.0+2.0. Of 84 patients taking antipsychotic medications, 74 (39.2%) were taking preferred antipsychotics and 10 (5.3%) were taking non-preferred antipsychotics. Eighty-eight participants (46.6%) reported rehabilitation (PT/OT/SLP) referrals, 49 (25.9%) social work referrals, 17 (9%) palliative care, and 22 (11.6%) hospice. There were no differences in cholinesterase inhibitor use (p=0.061), mean ACB score (p=0.348), use of preferred (p=0.560) or non-preferred (p=0.230) antipsychotics, rehabilitation referrals (p=0.719), or hospice referrals (p=0.928) between specialty and non-specialty cohorts. Individuals receiving specialty care were less likely to receive social work (13.9% vs. 34%), p=0.001) and palliative care (3.8% vs. 12.7%, p=0.034) referrals.

Conclusions Most individuals with moderate-advanced DLB observed received quality care relating to medications and rehabilitation referrals, however frequency of social work and palliative care referrals were low across both specialty and non-specialty cohorts. There is a need to increase availability of these services and connect individuals with DLB to these supports.

Authors/Disclosures
Rachael Burke, MD (University of Florida Department of Neurology) PRESENTER	Dr. Burke has nothing to disclose.
Zhigang Li, PhD	Dr. Li has nothing to disclose.
Hannah Jury	Mrs. Jury has nothing to disclose.
James E. Galvin, MD, MPH (University of Miami Miller School of Medicine)	Dr. Galvin has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Cognivue. Dr. Galvin has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Biogen. Dr. Galvin has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eisai. Dr. Galvin has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Galvin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for GE Healthcare. Dr. Galvin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Galvin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PassageBio. The institution of Dr. Galvin has received research support from National Institutes of Health. Dr. Galvin has received intellectual property interests from a discovery or technology relating to health care. Dr. Galvin has a non-compensated relationship as a Board of Directors with Alzheimer Association Southeast Florida Chapter that is relevant to AAN interests or activities. Dr. Galvin has a non-compensated relationship as a Board of Directors with Lewy Body Dementia Association that is relevant to AAN interests or activities. Dr. Galvin has a non-compensated relationship as a Board of Directors with Lewy Body Dementia Resource Center that is relevant to AAN interests or activities.
Julie A. Fields, PhD (Mayo Clinic)	The institution of Dr. Fields has received research support from National Institutes of Health. The institution of Dr. Fields has received research support from Patient-Centered Outcomes Research Institute.
Angela Taylor (Lewy Body Dementia Association)	Mrs. Taylor has received personal compensation for serving as an employee of Lewy Body Dementia Association.
Melissa Armstrong, MD, MSc, FAAN, FAAN (UF Department of Neurology)	The institution of Dr. Armstrong has received research support from National Institutes of Health. The institution of Dr. Armstrong has received research support from Florida Department of Health. The institution of Dr. Armstrong has received research support from Lewy Body Dementia Association. The institution of Dr. Armstrong has received research support from The Michael J. Fox Foundation. Dr. Armstrong has received personal compensation in the range of $5,000-$9,999 for serving as a DSMB member with Alzheimer's Clinical Trials Consortium. Dr. Armstrong has received personal compensation in the range of $5,000-$9,999 for serving as a DSMB member with Alzheimer's Disease Cooperative Study. Dr. Armstrong has received personal compensation in the range of $500-$4,999 for serving as a DSMB member with National Institutes of Health. Dr. Armstrong has a non-compensated relationship as a Member, Scientific Advisory Council with Lewy Body Dementia Association that is relevant to AAN interests or activities.

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