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The relationship between cognition and healthcare consultations was investigated through logistic regression. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Cognitive impairment was associated with more motor and non-motor symptoms, less antiparkinsonian but higher rates of dementia and antipsychotic medication, worse subjective health status and greater caregiver burden. A considerable proportion did not have a pre-established cognitive diagnosis. Care needs were high across the whole sample but higher in the cognitive impairment group. Home care and care home use was higher in the cognitive impairment group. However, use of healthcare consultations was similar between the groups and significantly fewer participants with cognitive impairment had had recent PD Nurse consultations. Worse cognitive impairment was associated with lower frequency of recent PD nurse and multidisciplinary therapy consultation (physiotherapy, massage, occupational therapy, speech training and general nursing). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Those with cognitive impairment have more severe PD, higher care needs and greater social care utilisation than those with normal cognition, yet use of health care services is similar or less. Cognitive impairment appears to be a barrier to PD nurse and multidisciplinary therapy consultations. This challenges current models of care: alternative models of care may be required to serve this population. <\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p> Parkinson\u2019s disease is a long-term progressive health condition. Over time, many people with Parkinson\u2019s develop problems with thinking and memory, called cognitive impairment. This can negatively impact the daily lives of the person with Parkinson\u2019s and their caregiver. It is also thought to be a barrier to accessing healthcare. How people with Parkinson\u2019s who have cognitive impairment use healthcare and detail of their care needs is not well known. We analysed data from a large sample of people with advanced Parkinson\u2019s from six European countries to investigate their symptoms, care needs and healthcare use. We compared those with cognitive impairment to (342 people) to those without cognitive impairment (333 people). We found that those with cognitive impairment had more severe Parkinson\u2019s across a range of symptoms compared to those without cognitive impairment. They also had more care needs, reported their health status to be worse, and their caregivers experienced greater strain from caring. Whilst use of other healthcare services was similar between the two groups, those with cognitive impairment were less likely to have recently seen a Parkinson\u2019s nurse than those without cognitive impairment. Further analysis showed an association between cognitive impairment and not having seen a Parkinson\u2019s nurse or therapist recently, taking psychiatric symptoms, functional disability and care home residence into account. Therapists included were physiotherapy, massage, occupational therapy, speech training and general nursing. These findings highlight unmet need. We suggest that healthcare should be more targeted to help this group of people, given their higher care needs. <\/jats:p><\/jats:sec>","DOI":"10.1177\/08919887231225484","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T10:58:01Z","timestamp":1705489081000},"page":"355-367","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Care Needs of Patients With Cognitive Impairment in Late-Stage Parkinson\u2019s Disease"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0951-7941","authenticated-orcid":false,"given":"Jennifer S.","family":"Pigott","sequence":"first","affiliation":[{"name":"Queen Square Institute of Neurology, University College London, London, UK"}]},{"given":"Bastiaan R.","family":"Bloem","sequence":"additional","affiliation":[{"name":"Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands"}]},{"given":"Stefan","family":"Lorenzl","sequence":"additional","affiliation":[{"name":"Institute for Palliative Care, Paracelsus Medical University, Salzburg, Austria"},{"name":"Department of Neurology and Palliative Care, University Hospital Agatharied, Hausham, Germany"},{"name":"Institute of Nursing Science and Practice, Salzburg, Austria"}]},{"given":"Wassilios G.","family":"Meissner","sequence":"additional","affiliation":[{"name":"CHU Bordeaux, Service de Neurologie des Maladies Neurod\u00e9g\u00e9n\u00e9ratives, IMNc, NS-Park\/FCRIN Network, Bordeaux, France"},{"name":"Univ. Bordeaux, CNRS, IMN, UMR5293, Bordeaux, France"},{"name":"Deptartment of Medicine, University of Otago, Christchurch, New Zealand"},{"name":"New Zealand Brain Research Institute, Christchurch, New Zealand"}]},{"given":"Per","family":"Odin","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Clinical Sciences Lund, Sk\u00e5ne University Hospital, Lund University, Lund, Sweden"}]},{"given":"Joaquim J.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Portugal"}]},{"given":"Richard","family":"Dodel","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, University Duisburg Essen, Essen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-6680","authenticated-orcid":false,"given":"Anette","family":"Schrag","sequence":"additional","affiliation":[{"name":"Queen Square Institute of Neurology, University College London, London, UK"}]}],"member":"179","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"bibr1-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27902"},{"key":"bibr2-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.120077"},{"key":"bibr3-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-315099"},{"key":"bibr4-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.04.020"},{"key":"bibr5-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1177\/0891988712464823"},{"key":"bibr6-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2020.05.016"},{"key":"bibr7-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12968"},{"key":"bibr8-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13262"},{"key":"bibr9-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/308097"},{"key":"bibr10-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21507"},{"key":"bibr11-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.06.025"},{"key":"bibr12-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10262"},{"key":"bibr13-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-021-01011-y"},{"key":"bibr14-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1177\/1471301219837776"},{"key":"bibr15-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23661"},{"key":"bibr16-08919887231225484","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-212735"},{"key":"bibr17-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.04.014"},{"key":"bibr18-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1177\/0891988713481269"},{"key":"bibr19-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-018-1184-3"},{"key":"bibr20-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2008.04.014"},{"key":"bibr21-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.24893"},{"key":"bibr22-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.17.5.427"},{"key":"bibr23-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23429"},{"key":"bibr24-08919887231225484","volume-title":"Recent Developments in Parkinsons Disease","volume":"2","author":"Fahn S","year":"1987"},{"key":"bibr25-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"bibr26-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/27.3.399"},{"key":"bibr27-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21844"},{"key":"bibr28-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(82)90033-4"},{"key":"bibr29-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21596"},{"key":"bibr30-08919887231225484","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2010.08.002"},{"key":"bibr31-08919887231225484","unstructured":"Schwab R, England A. 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