Longitudinal Association between Day Service Use and Regular Memory Clinic Attendance in Alzheimer's Disease: A...

Alzheimer's disease (AD) is a common progressive cognitive disease. Day services (DS) are provided through the Japanese public nursing care system. This study examined the association between DS utilization and regular memory clinic attendance among patients with AD.

We retrospectively analyzed the association between DS utilization and duration of regular memory clinic attendance in 302 patients with AD during a 3-year period. The patients were divided into 4 groups according to attendance duration. We examined the association between DS utilization and attendance duration. Next, we evaluated the 3-year efficacy of anti-AD drugs alongside non-pharmacological therapies. Cognitive function was assessed using the Revised Hasegawa Dementia Scale (HDS-R) and the Mini-Mental State Examination (MMSE) scores. Behavioral and psychological symptoms of dementia in AD were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q).

In bivariate analysis, attendance duration was significantly associated with age, number of family members, DS utilization, and first-visit scores for the NPI-Q, HDS-R, and MMSE. In Cox regression, DS non-utilization showed no significant association with regular attendance, though it trended toward higher dropout risk (HR = 1.25, 95% CI: 0.69-2.25, p = 0.44). HDS-R and MMSE scores declined significantly over time across all groups, consistent with the typical disease course.

DS non-utilization warrants investigation in larger cohorts as a potential marker of attrition risk. While this association does not imply direct causality due to potential residual confounding, monitoring DS engagement might assist clinicians in identifying patients at higher risk of clinic dropout.