A Meta-Analysis of Sex-Based Differences in Health Service Use for Persons Living With Dementia Between 2018 and 2020 in Four Canadian Provinces.

Background: Ensuring equitable healthcare services for persons with dementia is of utmost importance. Recent evidence points to sex-based differences in healthcare use in this population. However, available evidence is based on data from limited geographic regions and predates the COVID-19 pandemic, which is said to have further magnified disparities.

"There's Huge Value in Knowing What's Going On": a Mixed Methods Study to Explore Geriatricians' Perspectives on Best Practices for Information Transfer Between Hospital-Based Geriatricians and Primary Care Physicians.

Background: Geriatricians' work provides holistic recommendations to improve the health of older adults, considering medical, social, psychological, and functional domains. Their implementation most often relies on primary care physicians. Extant evidence suggests benefit from systematized information transfer between hospital-based specialists and primary care physicians.

Causal mediation analysis: what is it and how can it be used to inform practice and policy?

Background: Causal mediation, a quantitative analysis method, has the potential to be a valuable addition to any primary care provider, researcher, or student's toolbox.

Objective: This manuscript describes the theory behind causal mediation, provides a running example to help understand the application of this method in research, and explains how the results may be applied practically to help design appropriate interventions.

Methods And Application: Causal mediation allows an exploration of the mechanism of action of a primary care intervention on an outcome that may pass through a third variable that is on the causal pathway, a mediator.

Incident dementia across neighbourhood material deprivation: Implications for underdiagnosis.

Background: Evidence consistently demonstrates that lower socioeconomic status (SES) confers greater dementia risk and that it is associated with poorer outcomes including reduced access to care. Furthermore, underdiagnosis is a widespread issue in dementia. However, few studies investigate whether one of the poorer outcomes associated with lower SES is a greater degree of dementia underdiagnosis.

Prevalence and sequence of chronic conditions in older people with dementia: a multi-province, population-based cohort study.

Introduction: Comorbid chronic conditions contribute to increased health service use and poor outcomes for people with dementia, but there is little information about the prevalence of these conditions in this population.

Methods: We used linked administrative data from British Columbia (BC), Ontario (ON), Quebec (QC) and Prince Edward Island (PE) to identify a cohort of 287 453 individuals aged 65 years and older with prevalent dementia in April 2015, and followed this population until March 2020. We determined the prevalence of comorbid chronic conditions and ascertainment dates using Canadian Chronic Disease Surveillance System definitions, and used descriptive statistics to compare patterns across provinces.

The COVID-19 Pandemic and Dementia: a Multijurisdictional Meta-Analysis of the Impact of the First Two Pandemic Waves on Acute Health-care Utilization and Mortality in Canada.

Background: Previous studies on the impact of the coronavirus disease 2019 (COVID-19) pandemic on persons living with dementia (PLWD) were mostly conducted in a single jurisdiction or focused on a limited number of outcomes. Our study estimates the impact of the first two pandemic waves on emergency department (ED) visits (all-cause/ambulatory care sensitive conditions), hospitalizations (all-cause/30-day readmissions), and all-cause mortality in four Canadian jurisdictions.

Methods: Using administrative databases from Alberta, Ontario, Saskatchewan, and Quebec, we assembled two closed retrospective cohorts (2019/pre-pandemic control and 2020/pandemic) of PLWD aged 65+.

Development of an organizational typology of interprofessional primary care teams in Quebec, Canada: A multivariate analysis.

Background: This study aimed to develop an organizational typology of Interprofessional Primary Care (IPC) teams in Quebec, Canada, by describing their organizational profiles and assessing the association between the characteristics of the populations served and the organizational profiles.

Methods: This cross-sectional study was carried out using a finite mixture model of the 2021 financial monitoring data from the Ministry of Health and Social Services of Quebec. The population consisted of all IPC teams in Quebec (N = 368).

Identifying practices of information transfer between the hospital and primary care for older adults: a scoping review protocol.

Introduction: Transition of care from hospital to primary care has been recognised globally as a high-risk scenario for older patients' safety by the WHO. Indeed, sub-optimal care transitions are associated with increased mortality, morbidity and adverse events.Improving communication through timely and accurate clinical information transfer has been identified as a key component of optimal care transitions.

Knowledge and practices of youth awareness on death and dying in school settings: a systematic scoping review protocol.

Background: Awareness-raising and education have been identified as strategies to counter the taboo surrounding death and dying. As the favoured venue for youth education, schools have an essential role to play in informing future decision-makers. However, school workers are not comfortable addressing the subjects of death and dying, which, unlike other social issues, have no guidelines to influence awareness of these subjects in youth.

Prioritizing Protecting Oneself Over the COVID-19 Virus Versus Other Health and Social Needs Among Older Adults Living Alone: A Qualitative Study.

Background And Objectives: People aged 65 and older, deemed most "vulnerable" by public health, were targeted by the coronavirus disease 2019 protection measures, which sought to minimize physical contact and social activities. Older adults living alone were particularly affected by these measures. However, such measures meant to protect the older population may not have necessarily reflected older adults' individual prioritization choices.

Profiles of healthcare use of persons living with dementia: A population-based cohort study.

Aim: Persons living with dementia are a heterogeneous population with complex needs whose healthcare use varies widely. This study aimed to identify the healthcare use profiles in a cohort of persons with incident dementia, and to describe their characteristics.

Methods: This is a retrospective cohort study of health administrative data in Quebec (Canada).

Rural-Urban Differences in Healthcare Use in Persons With Dementia Between 2000 and 2019: A Quebec Population-Based Study.

Background: Rural persons with dementia face medical services gaps. This study compares the health service utilization of rural and urban community-dwelling individuals with incident dementia.

Methods: This study used a repeated annual cross-sectional cohort design spanning a period from 2000 to 2019 analyzing age-adjusted rates for 20 indicators of service use and mortality one year after diagnosis in Quebec administrative databases.

Considering inequities in national dementia strategies: breadth, depth, and scope.

Background: Considering that dementia is an international public health priority, several countries have developed national dementia strategies outlining initiatives to address challenges posed by the disease. These strategies aim to improve the care, support, and resources available to meet the needs of persons living with dementia and their care partners and communities. Despite the known impact of social determinants of health on dementia risk, care, and outcomes, it is unclear whether dementia strategies adequately address related inequities.

Sex Differences in Healthcare Utilization in Persons Living with Dementia Between 2000 and 2017: A Population-Based Study in Quebec, Canada.

Describe sex differences in healthcare utilization and mortality in persons with new dementia in Quebec, Canada. We conducted a repeated cohort study from 2000 to 2017 using health administrative databases. Community-dwelling persons aged 65+ with a new diagnosis of dementia were included.

Profiles of socially isolated community-dwelling older adults during the COVID-19 pandemic: A latent class analysis.

Objective: To identify different profiles of socially isolated older adults during the first wave of COVID-19 in Quebec, Canada.

Study Design: Cross-sectional data were obtained through a telehealth socio-geriatric risk assessment tool, ESOGER, administered to adults aged 70 years or more between April and July 2020 in Montreal, Canada.

Measures: Those living alone with no social contacts in the last few days were considered socially isolated.

Interprofessional Primary Care and Acute Care Hospital Use by People With Dementia: A Population-Based Study.

Purpose: Interprofessional primary care has the potential to optimize hospital use for acute care among people with dementia. We compared 1-year emergency department (ED) visits and hospitalizations among people with dementia enrolled in a practice having an interprofessional primary care team with those enrolled in a physician-only group practice.

Methods: A population-based, repeated cohort study design was used to extract yearly cohorts of 95,323 community-dwelling people in Ontario, Canada, newly identified in administrative data with dementia between April 1, 2005 and March 31, 2015.

The impact of including a medication review in an integrated care pathway: A pilot study.

Aim: The objective of the present study was to measure the impact of the intervention of combining a medication review with an integrated care approach on potentially inappropriate medications (PIMs) and hospital readmissions in frail older adults.

Methods: A cohort of hospitalized older adults enrolled in the French PAERPA integrated care pathway (the exposed cohort) was matched retrospectively with hospitalized older adults not enrolled in the pathway (unexposed cohort) between January 1st, 2015, and December 31st, 2018. The study was an analysis of French health administrative database.

Geriatric Syndromes in Older Adults Hospitalized with COVID-19 in Montreal, Canada.

Background: Older adults are more vulnerable to severe infection and mortality due to COVID-19. They have atypical presentations of the disease without respiratory symptoms, making early diagnosis clinically challenging. We aimed to compare the baseline characteristics, presentation, and disease course of older (≥70 yrs & ≥90 yrs) and younger (<70 yrs) patients hospitalized with COVID-19.

Quality indicator framework for primary care of patients with dementia.

Objective: To develop a framework of population-based primary care quality indicators adapted to patients with dementia and to identify a subset of stakeholder-driven priority indicators.

Design: Framework development was carried out through the selection of an initial framework based on a rapid review and identification of relevant indicators and enrichment based on existing dementia indicators and guidelines. Prioritization of indicators was carried out through a stakeholder survey.

Implementing a Telehealth Support Tool for Community-Dwelling Older Adults During the COVID-19 Pandemic: A Qualitative Investigation of Provider Experiences.

During the COVID-19 pandemic, policymakers had to quickly offer telehealth services to address older adults' needs. This study aimed to understand the experiences of providers who implemented a telephone-based telehealth tool named Socio-Geriatric Evaluation (ESOGER), which assessed health and social isolation risks in community-dwelling older adults in Quebec (Canada). This qualitative study used 20 semi-structured online/phone interviews with health and social service providers coming from publicly-funded healthcare facilities and community organizations.