CRITICAL gaps in outpatient ambulatory care utilization among older adults with dementia and mild cognitive impairment (MCI) have been revealed in a new study. Researchers analyzed data from 2,116 community-dwelling Medicare beneficiaries and found that while primary care visits remained high, patients with cognitive decline had significantly fewer visits to non-dementia-related specialists.
The study tracked 8,672 person-years of follow-up, with an average participant age of 82. Researchers found that while dementia and MCI patients had a higher probability of seeing dementia-related specialists—15% and 17%, respectively, compared to 12% for those with no cognitive impairment (NCI)—their overall engagement with other medical specialties was lower. Patients with dementia had 40% fewer visits to other specialists, while those with MCI had 10% fewer visits than their cognitively healthy counterparts.
Despite these declines, there was no compensatory increase in primary care visits, leading to an overall reduction in evaluation and management (E&M) services. Dementia and MCI were associated with 19% and 4% fewer E&M visits, respectively, compared to NCI patients. These findings suggest potential missed opportunities to address broader health concerns in patients with cognitive decline.
Given the importance of ambulatory care in managing dementia-related and other medical conditions, the study highlights a need for improved coordination of care. Ensuring that dementia patients receive comprehensive medical attention beyond cognitive health could be key to better long-term outcomes.
Reference: Y Chen et al. The Association of Dementia and Mild Cognitive Impairment With Outpatient Ambulatory Care Utilization in the Community. J Am Geriatr Soc. 2025. doi: 10.1111/jgs.19446. [Online ahead of print].
Anaya Malik | AMJ
