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Utilization of Occupational and Physical Therapy Home Health Visits Among People Living With Dementia With Varying Social Determinants of Health
Lassell Rebecca K F, Muruganand Ashwath, Gan Adeline, Fletcher Jason, Lin Shih-Yin, Brody Abraham A. Journal of the American Medical Directors Association, 2025-09-15
Topic: Risk, prevention and care in population studies
We sought to identify patterns in occupational therapy (OT) and physical therapy (PT) home health care visits among people living with dementia (PLWD) by (1) level of function care partner report compared with administrative data, (2) race and ethnicity, and (3) level of socioeconomic resources. A secondary analysis. We used data collected from 152 PLWD-care partner dyads enrolled in a hybrid type I effectiveness trial at a large, urban, Medicare-certified, nonprofit home health care agency in the northeastern United States. Function was measured with the Caregiver Quality of Life Assistance in Activities of Daily Living (ADLs) and Assistance in Instrumental Activities of Daily Living (IADLs) subscales. PLWD's addresses were used to measure socioeconomic deprivation using the Area Deprivation Index (ADI). The number of OT/PT visits were calculated for the first 30 days of enrollment in the study with care partners' reports and administrative data. Visit data were compared and analyzed using a Wilcoxon signed-rank test and a zero-inflated negative binomial regression. Differences in the number of OT/PT visits was compared across racial and ethnic groups, ADI quartiles, and level of function using regression and controlling for education and comorbidities. Hispanic (mean: 1.4, SD: 0.754) and non-Hispanic Black (mean: 1.6, SD: 0.769) PLWD had significantly lower ADL function at baseline than White individuals (mean: 2.103, SD: 0.882) (P = .002) that increased over 30 days (P = .513). A significant difference existed between care partner and administrative reports in the number of PT visits (F = 0.97, P = .459) but not OT visits. There were no differences in OT/PT utilization based on race and ethnicity and socioeconomic resources. Caregiver report was not reliable for PT visits received in home health care. OT/PT home health care utilization may help reduce disparities in ADL function across racial and ethnic groups.
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APA 7th
Lassell Rebecca K, F., Ashwath, M., Adeline, G., Jason, F., Shih-Yin, L., & Brody Abraham, A. (2025). Utilization of Occupational and Physical Therapy Home Health Visits Among People Living With Dementia With Varying Social Determinants of Health. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2025.105872
Vancouver
Lassell Rebecca K F, Ashwath M, Adeline G, Jason F, Shih-Yin L, Brody Abraham A. Utilization of Occupational and Physical Therapy Home Health Visits Among People Living With Dementia With Varying Social Determinants of Health. Journal of the American Medical Directors Association. 2025. doi:10.1016/j.jamda.2025.105872. PMID: 40947101.
BibTeX
@article{lassellrebeccak2025-40947101,
author = {Lassell Rebecca K, F. and Ashwath, Muruganand and Adeline, Gan and Jason, Fletcher and Shih-Yin, Lin and Brody Abraham, A.},
title = {{Utilization of Occupational and Physical Therapy Home Health Visits Among People Living With Dementia With Varying Social Determinants of Health}},
journal = {Journal of the American Medical Directors Association},
year = {2025},
doi = {10.1016/j.jamda.2025.105872},
pmid = {40947101},
url = {https://doi.org/10.1016/j.jamda.2025.105872}
}
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Key findings
- We sought to identify patterns in occupational therapy (OT) and physical therapy (PT) home health care visits among people living with dementia (PLWD) by (1) level of function care partner report compared with administrative data, (2) race and ethnicity, and (3) level of socioeconomic resources.
- Hispanic (mean: 1.4, SD: 0.754) and non-Hispanic Black (mean: 1.6, SD: 0.769) PLWD had significantly lower ADL function at baseline than White individuals (mean: 2.103, SD: 0.882) (P = .002) that increased over 30 days (P = .513).
- A significant difference existed between care partner and administrative reports in the number of PT visits (F = 0.97, P = .459) but not OT visits.
Why it matters
This secondary analysis of 152 people living with dementia and their care partners examined occupational and physical therapy home health visits by function, race and ethnicity, and socioeconomic resources. It reports patterns of therapy use, not any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 32/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Medical Directors Association) |
| Journal's citation record | 2 / 4 | Journal of the American Medical Directors Association: journal h-index 172 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-17) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Abraham A. Brody: h-index 29 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | New York University: institution h-index 1,612 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40947101) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 32 / 100 | — |
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