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Dementia and co‐occurring chronic conditions: a systematic literature review to identify what is known and where are the gaps in the evidence?
Author(s) -
Snowden Mark B.,
Steinman Lesley E.,
Bryant Lucinda L.,
Cherrier Monique M.,
Greenlund Kurt J.,
Leith Katherine H.,
Levy Cari,
Logsdon Rebecca G.,
Copeland Catherine,
Vogel Mia,
Anderson Lynda A.,
Atkins David C.,
Bell Janice F.,
Fitzpatrick Annette L.
Publication year - 2017
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4652
Subject(s) - dementia , systematic review , psychology , medline , gerontology , medicine , disease , political science , law
Objective The challenges posed by people living with multiple chronic conditions are unique for people with dementia and other significant cognitive impairment. There have been recent calls to action to review the existing literature on co‐occurring chronic conditions and dementia in order to better understand the effect of cognitive impairment on disease management, mobility, and mortality. Methods This systematic literature review searched PubMed databases through 2011 (updated in 2016) using key constructs of older adults, moderate‐to‐severe cognitive impairment (both diagnosed and undiagnosed dementia), and chronic conditions. Reviewers assessed papers for eligibility and extracted key data from each included manuscript. An independent expert panel rated the strength and quality of evidence and prioritized gaps for future study. Results Four thousand thirty‐three articles were identified, of which 147 met criteria for review. We found that moderate‐to‐severe cognitive impairment increased risks of mortality, was associated with prolonged institutional stays, and decreased function in persons with multiple chronic conditions. There was no relationship between significant cognitive impairment and use of cardiovascular or hypertensive medications for persons with these comorbidities. Prioritized areas for future research include hospitalizations, disease‐specific outcomes, diabetes, chronic pain, cardiovascular disease, depression, falls, stroke, and multiple chronic conditions. Conclusions This review summarizes that living with significant cognitive impairment or dementia negatively impacts mortality, institutionalization, and functional outcomes for people living with multiple chronic conditions. Our findings suggest that chronic‐disease management interventions will need to address co‐occurring cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd.