{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:07:13Z","timestamp":1780636033609,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":85,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UM1TR004929"],"award-info":[{"award-number":["UM1TR004929"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["A&amp;amp;D Transl Res &amp;amp; Clin Interv"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Caregiver support interventions can reduce depression symptoms for caregivers of persons living with cognitive impairment and dementia (PwCI). However, few studies have assessed the effect of caregiver counseling support on the health\u2010care use of the PwCI. The objective of this study was to assess if caregiver participation in mental health counseling can slow health\u2010care use in PwCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The analysis included all PwCI with cognitive impairment identified through the electronic health records as seen in either the Wake Forest Memory Counseling Program (MCP), providing mental health counseling, and\/or the Kulynych Geriatric Consult Clinic (KGCC), providing memory assessment and care, between August 1, 2016, and February 28, 2020. Health\u2010care use (emergency department [ED] use and hospitalization) pre\u2010 and post\u2010index date were compared between PwCI who received only medical care (MC) and those who received both medical and mental health care (MC+MHC) using a mixed effects logistic regression model adjusted for age, sex, race, ethnicity, KGCC visit type, and primary diagnosis. Hypothesis testing was accomplished with two\u2010sided Wald tests, and odds ratios (ORs) were used to characterize effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Compared to the 1 year pre\u2010index visit, PwCI who received medical care (MC) only experienced an increase in ED visits (OR 1.73,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001) and hospitalizations (OR 1.42,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001) in the 1 year post\u2010index visit. In contrast, PwCI and caregivers who received medical + mental health care (MC+MHC)\u00a0did not experience increases in ED visits (OR 1.13,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.5104) or hospitalizations (OR 1.15,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.4849). Compared to MC only, PwCI who received MC+MHC had significantly lower odds of post\u2010 versus pre\u2010ED visits (OR 0.65,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0322) but not hospitalizations (OR 0.81,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.3270).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Providing mental health counseling to caregivers in addition to medical care for the PwCI may reduce ED visits among PwCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This study tests whether caregiver participation in mental health counseling can slow health\u2010care use in the person living with dementia (PLWD).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>PLWDs who received medical only visits experienced an increase in emergency department (ED) visits compared to those who received both medical and mental health care.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Providing mental health counseling to caregivers in addition to medical care for the PLWD may reduce ED visits among PLWD.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/trc2.70159","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T09:18:51Z","timestamp":1758705531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mental health counseling for caregivers is associated with a slower rate of health\u2010care use in people with dementia"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-3706","authenticated-orcid":false,"given":"Mia","family":"Yang","sequence":"first","affiliation":[{"name":"Section on Gerontology &amp; Geriatric Medicine, Department of Internal Medicine Atrium Health Wake Forest Baptist Health  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Collier","sequence":"additional","affiliation":[{"name":"Memory Counseling Program Atrium Health Wake Forest Baptist Health  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Rigdon","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Data Science Wake Forest School of Public Health Sciences  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina E.","family":"Hugenschmidt","sequence":"additional","affiliation":[{"name":"Section on Gerontology &amp; Geriatric Medicine, Department of Internal Medicine Atrium Health Wake Forest Baptist Health  Winston Salem North Carolina USA"},{"name":"Memory Counseling Program Atrium Health Wake Forest Baptist Health  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Alzheimer's Disease Facts and Figures. 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Center for Loss & Life Transition. Accessed December 18 2024.https:\/\/www.centerforloss.com\/bookstore\/dementiaworkbook\/"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097\u20100258(19981015)17:19<2265::aid\u2010sim918>3.0.co;2\u2010b"},{"key":"e_1_2_9_21_1","unstructured":"R Core Team:A Language and Environment for Statistical Computing_.R Foundation for Statistical Computing Vienna Austria.2023.https:\/\/www.R\u2010project.org\/"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207674"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12020"},{"key":"e_1_2_9_24_1","unstructured":"CMS.gov.Guiding an Improved Dementia Experience (GUIDE) Model. Accessed April 14 2025.https:\/\/www.cms.gov\/priorities\/innovation\/innovation\u2010models\/guide"}],"container-title":["Alzheimer's &amp; Dementia: Translational Research &amp; Clinical Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/trc2.70159","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/trc2.70159","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/trc2.70159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:52:18Z","timestamp":1780635138000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/trc2.70159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/trc2.70159"],"URL":"https:\/\/doi.org\/10.1002\/trc2.70159","archive":["Portico"],"relation":{},"ISSN":["2352-8737","2352-8737"],"issn-type":[{"value":"2352-8737","type":"print"},{"value":"2352-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70159"}}