[Utilisation of Speech/Language and Occupational Therapy in Dementia and Mild Cognitive Impairment: Insights from...

Non-pharmacological therapies such as speech/ language and occupational therapy are considered essential components in the care of people with dementia and mild cognitive impairment. However, data on the actual utilisation of these services in routine care are lacking. This study aimed to examine the utilisation of these services using routine data.Based on routine data from the research database of the Institute for Applied Health Research Berlin (2017-2022), annual utilisation densities of speech/ language therapy and occupational therapy were calculated in relation to the annual prevalence of dementia/mild cognitive impairment and analysed by federal state. In addition, all individuals with an initial diagnosis in 2017 were followed over a five-year period as part of a longitudinal study to examine the use of therapeutic services.The six-year prevalence was 5.1%, with an annual average of n=85,496 individuals identified with dementia/mild cognitive impairment. The mean annual utilisation densities were 2.5% for speech/language therapy and 7.0% for occupational therapy. North Rhine-Westphalia had the highest, Bremen the lowest utilisation density. In the longitudinal analysis, 9.4% of affected individuals (n=13,746) received at least one therapy prescription. Utilisation decreased with disease duration, while home visits became more frequent.Despite established guideline recommendations, speech/language and occupational therapy remain underutilised in the care of people with dementia or mild cognitive impairment in Germany. To address these care gaps, targeted information strategies for stakeholders and the implementation of interdisciplinary care pathways in routine practice are needed.