{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T16:31:26Z","timestamp":1786379486631,"version":"build-2736575974"},"reference-count":65,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Economic and Social Research Council (UK) and the National Institute for Health Research","award":["ES\/S010351\/1"],"award-info":[{"award-number":["ES\/S010351\/1"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Newly diagnosed people with dementia and Alzheimer's disease may have varying levels of functional difficulties in which help is required. Little is known about how their needs are met, the associations of needs with care dyad background characteristics and how these characteristics are associated with each other.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We investigated the pathways between background characteristics, functional difficulties (need) and receipt of help.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The sample included 672 newly diagnosed people with dementia and their carers. Four activities of daily living (ADLs), three instrumental activities of daily living (IADLs) and receipt of help in these activities were used to define needs and unmet needs. Receipt of adequate support from health and social care services was also reported. Regression and path models explored the associations with background characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most people with dementia had at least one ADL (42%) or IADL (83%) difficulty. Among those who had a difficulty, 50% and 31% had at least one unmet ADL or IADL need, respectively. Support from health and social care services was reported as inadequate by 29%. Many background characteristics (age, gender, education, homeownership, urban-rural location, area deprivation) were associated with receipt of help through functional limitations and\/or whether the carer was spouse or coresident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although people newly diagnosed with dementia had fewer ADL than IADL difficulties, unmet need was proportionally higher for ADLs than IADLs. The findings point to possible barriers to receiving help shaped by complex pathways through sociodemographic factors, current levels of functioning and carer characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261459015","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:27:56Z","timestamp":1782311276000},"page":"1519-1535","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional difficulties, receipt of help, and unmet needs among people with newly diagnosed dementia: Results from the DETERMIND project"],"prefix":"10.1177","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5532-8746","authenticated-orcid":false,"given":"Sanna","family":"Read","sequence":"first","affiliation":[{"name":"London School of Economics and Political Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Brimblecombe","sequence":"additional","affiliation":[{"name":"London School of Economics and Political Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6445-2415","authenticated-orcid":false,"given":"Ben","family":"Hicks","sequence":"additional","affiliation":[{"name":"Institute of Mental Health, University of Nottingham, Nottingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5256-505X","authenticated-orcid":false,"given":"Bo","family":"Hu","sequence":"additional","affiliation":[{"name":"London School of Economics and Political Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"King","sequence":"additional","affiliation":[{"name":"London School of Economics and Political Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3096-2721","authenticated-orcid":false,"given":"Raphael","family":"Wittenberg","sequence":"additional","affiliation":[{"name":"London School of Economics and Political Science"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31363-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2019.1695741"},{"key":"e_1_3_3_4_2","unstructured":"WHO. Global action plan on the public health response to dementia 2017 - 2025. Report World Health Organization Geneva 2017."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12678"},{"key":"e_1_3_3_6_2","first-page":"1","article-title":"Comparison of unmet care needs across the dementia trajectory: findings from the maximizing independence at home study","volume":"2","author":"Hodgson NA","year":"2014","unstructured":"Hodgson NA, Black BS, Johnston D, et al. Comparison of unmet care needs across the dementia trajectory: findings from the maximizing independence at home study. J Geriatr Palliat Care 2014; 2: 1\u20135.","journal-title":"J Geriatr Palliat Care"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2021.2017846"},{"key":"e_1_3_3_8_2","first-page":"459","article-title":"Adverse consequences of unmet needs for care in high-need\/high-cost older adults","volume":"75","author":"Beach SR","year":"2020","unstructured":"Beach SR, Schulz R, Friedman EM, et al. Adverse consequences of unmet needs for care in high-need\/high-cost older adults. J Gerontol B Psychol Sci Soc Sci 2020; 75: 459\u2013470.","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1057\/pt.2011.17"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1131-1"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000478850"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610217001491"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1403494819890800"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.03.043"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1017\/S104161022300042X"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.2307\/2137284"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4879"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.70164"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1471301217733233"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-210724"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610218002296"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-8-132"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12549"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X22000885"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.70066"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.14093"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.31389\/jltc.33"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.70348"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12323"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-150935"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac228"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.05.009"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/31.2.285"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-150692"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-180275"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-180531"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2017.1390732"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.00495.x"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5246"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/25.2.113"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.2.5.669"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.4135\/9780857024725"},{"key":"e_1_3_3_43_2","unstructured":"ONS. 2011 rural\/urban classification - Office for National Statistics https:\/\/www.ons.gov.uk\/methodology\/geography\/geographicalproducts\/ruralurbanclassifications\/2011ruralurbanclassification (2016 accessed 25 January 2021)."},{"key":"e_1_3_3_44_2","unstructured":"Ministry of Housing Community and Local Government. English indices of deprivation 2019: Postcode Lookup http:\/\/imd-by-postcode.opendatacommunities.org\/imd\/2019 (2019 accessed 26 January 2021)."},{"key":"e_1_3_3_45_2","unstructured":"Muth\u00e9n LK Muth\u00e9n BO. Mplus User\u2019s Guide. Eight edit. Los Angeles CA: Muth\u00e9n & Muth\u00e9n www.StatModel.com (2017 accessed 10 July 2020)."},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.2.425"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2012.640596"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"e_1_3_3_49_2","volume-title":"Principles and Practice of Structural Equation Modeling. 4th Edition","author":"Kline RB","year":"2016","unstructured":"Kline RB. Principles and Practice of Structural Equation Modeling. 4th Edition. New York: Guilford Press, 2016."},{"key":"e_1_3_3_50_2","unstructured":"Muth\u00e9n BO du Toit SH Spisic D. Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes. Technical report UCLA. 1997."},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-3737.2005.00191.x"},{"key":"e_1_3_3_52_2","unstructured":"Alzheimer\u2019s Society. Left to Cope Alone: The unmet support needs after a dementia diagnosis https:\/\/www.alzheimers.org.uk\/sites\/default\/files\/2022-07\/left-to-cope-alone-after-diagnosis-report.pdf (2022 accessed 30 January 2024)."},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.2307\/jj.1666827.18"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaging.2018.01.004"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06736-2"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-13-51"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05416-x"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1332\/175982721X16605972092524"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1177\/14713012241237673"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1177\/070674370505000207"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/1471301218816250"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11091319"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2022.2053833"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1177\/0733464820952995"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-05613-x"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1177\/23337214221092886"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261459015","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877261459015","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261459015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T16:15:15Z","timestamp":1786378515000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877261459015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":65,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/13872877261459015"],"URL":"https:\/\/doi.org\/10.1177\/13872877261459015","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]}}}