Nonpharmacological therapies and provision of aids in outpatient dementia networks in Germany: utilization rates and associated factors

Figures & data

Table 1 Sociodemographic and clinical characteristics of the total study sample (n=560) and differences between physician-associated networks (n=203) and other networks (n=357)

Variable	Measure	Statistic	Missing values*	Total n=560	Physician-associated networks n= 203	Other networks n=357	P-value
Age	Years	Mean (SD)	5	79.7 (8.4)	77.9 (8.0)	80.3 (8.8)	P≤0.001a
Sex	Female	Frequency	3	325 (58.3%)	100 (49.2%)	225 (63.5%)	P≤0.001d
Social index	Scheuch–Winkler (index)	Frequency	151
	Low			248 (60.6%)	88 (59.1%)	160 (61.5%)	P=0.164b
	Middle			121 (29.6%)	41 (27.5%)	80 (30.7%)
	High			40 (9.8%)	20 (13.4%)	20 (7.7%)
Formal diagnosis	Yes	Frequency	18	503 (92.8%)	177 (92.2%)	326 (93.1%)	P=0.729d
Type of dementia		Frequency	84
Alzheimer’s dementia				211 (44.3%)	81 (50.6%)	130 (41.1%)	P=0.374b
Vascular dementia				92 (19.3%)	24 (15.0%)	68 (21.5%)
Unspecific				155 (32.6%)	50 (31.3%)	105 (33.2%)
Others				18 (3.8%)	5 (3.1%)	13 (4.1%)
Region	Rural	Frequency	7	100 (18.1%)	41 (20.4%)	59 (16.8%)	P=0.302d
Living	Alone	Frequency	2	119 (21.3%)	34 (16.9%)	85 (23.9%)	P=0.067d
Cognitive impairment	FAST stage (1–7)	Median	20	6.0	6.0	7.0	P≤0.005c
Functional status	IADL score (0–8)	Mean (SD)	49	1.9 (1.8)	2.8 (2.0)	1.5 (1.6)	P≤0.005a
Comorbidity	Number of morbidities	Mean (SD)	39	3.9 (2.1)	3.6 (1.9)	4 (2.2)	P=0.012a
Age (caregiver)	Years	Mean (SD)	5	63.9 (12.9)	66.0 (13.4)	62.6 (12.5)	P≤0.005a
Sex (caregiver)	Female	Frequency	5	416 (74.9%)	147 (72.8%)	269 (76.2%)	P=0.415d
Caregiver relationship	Yes	Frequency	2
Spouse/partner				280 (50.2%)	129 (63.9%)	151 (42.3%)	P≤0.001b
Daughter/son				206 (36.9%)	67 (33.2%)	139 (39.0%)
Daughter/son-in-law				21 (3.8%)	1 (0.5%)	20 (5.6%)
Others				51 (9.1%)	5 (2.5%)	46 (12.9%)

Notes:

* Cases with missing values were excluded from the calculation of frequencies and means.

a One-sample t-test;

b chi-square test;

c Mann–Whitney U test;

d Fisher’s exact test.

Abbreviations: FAST, Functional Assessment Staging; IADL, Instrumental Activities of Daily Living; SD, standard deviation.

Table 2 Utilization of nonpharmacological therapies and provision of aids for the total study sample (n=560) and differences between physician-associated networks (n=203) and other networks (n=357)

Variable	Measure	Statistic	Missing values*	Total n=560	Physician-associated networks n=203	Other networks n=357	P-value
Physiotherapy	Treatment (yes)	Frequency	55	123 (24.4%)	37 (21.3%)	86 (26.0%)	P=0.276b
	Number visits per PWD	Mean (SD)	11	21.4 (16.2)	16.5 (14.6)	23.1 (16.5)	P=0.065a
Occupational therapy	Treatment (yes)	Frequency	66	78 (15.8%)	33 (19.2%)	45 (14.0%)	P=0.154b
	Number visits per PWD	Mean (SD)	5	20.9 (12.9)	19.5 (12.4)	21.9 (13.3)	P=0.435a
Mobility aid	Yes	Frequency		328 (58.6%)	95 (46.7%)	233 (65.2%)	P≤0.001b
	Number of aids per PWD	Mean (SD)		1.0 (1.1)	0.8 (1.0)	1.2 (1.1)	P≤0.001a
Personal	Yes	Frequency		435 (77.7%)	132 (65.0%)	303 (84.9%)	P≤0.001b
hygiene aid	Number of aids per PWD	Mean (SD)		2.4 (2.0)	1.7 (1.8)	2.8 (2.1)	P≤0.001a
Medical aid	Yes	Frequency		323 (57.7%)	127 (62.6%)	196 (54.9%)	P=0.017b
	Number of aids per PWD	Mean (SD)		0.7 (0.7)	0.8 (0.7)	0.7 (0.7)	P=0.993a
Sensory aid	Yes	Frequency		510 (91.1%)	193 (95.1%)	317 (88.8%)	P=0.019b
	Number of aids per PWD	Mean (SD)		1.1 (0.5)	1.2 (0.5)	1.1 (0.6)	P=0.780a

Notes:

* Cases with missing values were excluded from the calculation of frequencies and means.

a One-sample t-test;

b Fisher’s exact test. Mobility aids could include: wheelchair, stair lifter, walking stick, crutch, or walker. Personal hygiene aid could include: nursing bed, nursing covers, nursing insets, toilet chair, toilet seat, bathtub seat, bath lifter, handles, or decubitus mattress. Medical aid could include: sphygmomanometer, blood glucose meter, or breath intake meter. Sensory aid could include: hearing aid or glasses.

Abbreviations: PWD, person with dementia; SD, standard deviation.

Table 3 Multivariable associations between physiotherapy and occupational therapy, network association, sociodemographic, and clinical variables

Variables	Therapy – logistic regression
	Physiotherapy				Occupational therapy
	OR	95% CI		P-value	OR	95% CI		P-value
Sex (female)	0.973	0.692	1.368	0.877	0.773	0.328	1.825	0.558
Age	1.032	0.988	1.077	0.146	1.056	1.027	1.085	≤0.001
Number comorbidities	1.167	1.021	1.334	0.023	1.068	0.926	1.232	0.361
Functional status (IADL)	0.906	0.798	1.029	0.130	0.973	0.860	1.100	0.664
Network (medical)	0.792	0.423	1.485	0.469	1.340	0.744	2.414	0.328
Region (rural)	0.885	0.487	1.608	0.690	0.579	0.280	1.198	0.141

Abbreviations: CI, confidence interval; IADL, Instrumental Activities of Daily Living; OR, odds ratio.

Table 4 Multivariable associations between aids, type of network, sociodemographic, and clinical variables

Variables	Aids – logistic regression
	Mobility (wheelchair, stair lifter, walking stick, crutch, walker)				Nursing personal hygiene (nursing bed, nursing covers, nursing insets, toilet chair, toilet seat, bathtub seat, bath lifter, handles, decubitus mattress)				Medical (sphygmomanometer, blood glucose meter, breath intake meter)				Sensory (hearing aid, glasses)
	OR	95% CI		P-value	OR	95% CI		P-value	OR	95% CI		P-value	OR	95% CI		P-value
Sex (female)	1.771	1.097	2.857	0.019	2.747	1.801	4.190	≤0.001	0.648	0.365	1.152	0.140	0.539	0.232	1.252	0.151
Age	0.919	0.885	0.953	≤0.001	0.935	0.913	0.958	≤0.001	0.999	0.967	1.031	0.955	0.947	0.910	0.985	0.007
Number comorbidities	1.445	1.233	1.692	≤0.001	1.376	1.213	1.562	≤0.001	1.274	1.142	1.422	≤0.001	1.089	0.870	1.362	0.455
Functional status (IADL)	0.704	0.630	0.785	≤0.001	0.611	0.505	0.740	≤0.001	1.058	0.9233	1.212	0.416	1.335	0.998	1.785	0.051
Network (physician)	0.990	0.602	1.625	0.968	0.664	0.362	1.221	0.188	1.414	0.803	2.489	0.230	2.110	1.042	4.274	0.038
Region (rural)	1.619	0.709	3.698	0.252	1.940	0.594	6.337	0.272	0.969	0.694	1.353	0.857	2.400	0.811	7.106	0.114

Abbreviations: CI, confidence interval; IADL, Instrumental Activities of Daily Living; OR, odds ratio.