The Impact of Home Health Physical Therapy on Medicare Beneficiaries With a Primary Diagnosis of Dementia
Journal of the American Geriatrics Society: The Impact of Home Health Physical Therapy on Medicare Beneficiaries With a Primary Diagnosis of Dementia
Abstract
BACKGROUND:
Dementia is a leading cause of disability for adults older than 65 years. Exercise intervention slows functional decline and improves balance; however, the efficacy of physical therapy (PT) services for persons with dementia is unknown. The purpose of this study is to assess the effect of home health PT services on physical function for Medicare beneficiaries with a primary diagnosis of dementia.
DESIGN:
Observational cohort study using a combined Medicare data set of home health beneficiaries; we performed augmented inverse probability weighted regression with demographic, comorbidity, and symptom-level characteristics analyzed as covariates.
SETTING:
Home healthcare, United States, 2012.
PARTICIPANTS:
Medicare beneficiaries who had a primary diagnosis of dementia and home health function evaluations at discharge (n = 1477).
INTERVENTION:
PT treatment, examined by (1) any PT and (2) PT visit number.
MEASUREMENT:
Improvement in composite activity of daily living (ADL) scores from home health admit to discharge.
RESULTS:
Any PT increased the probability of improvement in ADLs by 15.2% (P < .001). Compared to 1 to 5 PT visits, 6 to 13 visits increased the probability of ADL improvement by 11.6% (P < .001).
CONCLUSION:
PT intervention is beneficial for ADL function improvement in Medicare home health beneficiaries with a primary diagnosis of dementia.
© 2020 The American Geriatrics Society. [Members Stevens-Lapsely and Falvey are co-authors.]
Jason Falvey, DPT, PHD is on the Geriatric Research team at Yale and has been producing a series of outcome based research specific to home health PT. He often stresses the need to look at the dose-response for any of our patients. It would be inappropriate to do weeks and weeks of therapy for this population. However, providing a closely prescribed and monitored amount of Physical Therapy for someone with dementia is both beneficial and appropriate.
