{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T05:13:36Z","timestamp":1789881216226,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T00:00:00Z","timestamp":1742601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T00:00:00Z","timestamp":1742601600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG079226"],"award-info":[{"award-number":["R01AG079226"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG072559"],"award-info":[{"award-number":["R01AG072559"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG015819"],"award-info":[{"award-number":["R01AG015819"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG022018"],"award-info":[{"award-number":["R01AG022018"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG017917"],"award-info":[{"award-number":["R01AG017917"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG072975"],"award-info":[{"award-number":["P30AG072975"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ambulatory care is critical in delivering interventions for dementia and mild cognitive impairment (MCI), from basic services to novel therapeutics. Yet, little is known regarding how community\u2010dwelling persons with dementia\/MCI interact with clinicians in outpatient ambulatory settings. We assessed associations of dementia\/MCI with outpatient ambulatory evaluation and management (E&amp;M) visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 2116 community\u2010dwelling participants in Rush Alzheimer's Disease Center cohorts, with linked fee\u2010for\u2010service Medicare claims. Annually from 2011 to 2019, cohort neuropsychologic evaluations classified participants as dementia, MCI, or no cognitive impairment (NCI). Across groups, we compared annual probability of visiting providers and number of E&amp;M visits, using repeated measures logistic or generalized Poisson mixed effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across 8672 person\u2010years (PY) of follow\u2010up, the mean age was 82 (SD 7.6) years; 77% of PYs were among females and 24% among Black participants. Controlling for demographics and comorbidity, the annual predicted probability of primary care visits was high in all groups (86%\u201392%). Although there were few visits with dementia\u2010related specialists, we found a higher probability of these visits among those with dementia (15%) and MCI (17%) than NCI (12%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009, dementia vs. NCI;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, MCI vs. NCI). There were striking differences in visits to other medical specialties: the mean number of annual visits was 40% lower for those with dementia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 10% lower for MCI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than NCI. Overall, dementia and MCI were associated with 19% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) fewer E&amp;M visits, respectively, compared to NCI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older adults with dementia and MCI interact with primary care providers regularly and are more likely to use dementia\u2010related specialists than those with NCI. Yet, we found lower utilization of other medical specialties, without compensatory increases in primary care, leading to fewer overall E&amp;M visits, even in MCI. Together, the findings may suggest lost opportunities to address the scope of health issues in vulnerable groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19446","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T13:18:35Z","timestamp":1742735915000},"page":"1819-1826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Association of Dementia and Mild Cognitive Impairment With Outpatient Ambulatory Care Utilization in the Community"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1045-0501","authenticated-orcid":false,"given":"Yi","family":"Chen","sequence":"first","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Internal Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan D.","family":"James","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Internal Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana W.","family":"Capuano","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mousumi","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health, University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mellanie V.","family":"Springer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Program University\u00a0of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6642-7558","authenticated-orcid":false,"given":"Brittney S.","family":"Lange\u2010Maia","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Family and Preventive Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa L.","family":"Barnes","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Psychiatry and Behavioral Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie P. 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