{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T12:20:34Z","timestamp":1776774034721,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>During the COVID\u201019 pandemic, long\u2010term care (LTC) providers limited services, and many persons with dementia (PWDs) avoided contact. This study examined whether reduced service use was driven primarily by provider\u2010imposed restrictions or user concerns about infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey was conducted in Japan (January\u2013February 2023) among 436 care managers to assess changes in operations, user intentions, and living conditions of PWDs. Hierarchical logistic regression identified predictors of reduced use, and structural equation modeling (SEM) explored associations among provider\/user factors, service utilization, and living conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among respondents, 58% reported decreased service use. Facility closures (odds ratio [OR]\u2009=\u20091.68), users' desire to discontinue services (OR\u2009=\u20092.35), and cancellations of short\u2010term stays (OR\u2009=\u20092.58) were significantly associated with reduced utilization. User\u2010related factors had a greater impact than provider\u2010related ones. The SEM showed good fit (non\u2010significant chi\u2010square, acceptable indices). Reduced service use was linked to worsening daily life for PWDs; in 89% of affected cases, patients relied on family care, often leading to increased caregiver burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>User\u2010initiated service avoidance, compounded by provider restrictions, contributed to decreased LTC use and worsened outcomes for PWDs. Policy responses should strengthen flexible home\u2010 and community\u2010based services and provide enhanced caregiver support to ensure care continuity during future public health crises.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70455","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T01:03:58Z","timestamp":1773882238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Survey on Changes in Long\u2010Term Care Service Utilization Among Individuals With Dementia During the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4015-6056","authenticated-orcid":false,"given":"Kenta","family":"Hirohama","sequence":"first","affiliation":[{"name":"Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"},{"name":"Sakamidorii Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hungu","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2882-1009","authenticated-orcid":false,"given":"Yuji","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"},{"name":"Department of Rehabilitation, Faculty of Health Sciences Hiroshima Cosmopolitan University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junpei","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"},{"name":"Department of Rehabilitation, Faculty of Health Sciences Hiroshima Cosmopolitan University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5498-7224","authenticated-orcid":false,"given":"Masahiro","family":"Akishita","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Okamura","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12853"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14657"},{"key":"e_1_2_13_4_1","volume-title":"Long\u2010Term Care Report: Trends, Challenges and Opportunities in an Ageing Society. 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