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Evaluation of the South Korean national long-term care insurance-funded cognitive function training programme for older people with mild dementia

Authors
Ju, Yeong JunNam, Chung MoLee, Sang GyuPark, SoheeHahm, Myung-IlPark, Eun-Cheol
Issue Date
Sep-2019
Publisher
Oxford University Press
Keywords
Special dementia rating; Dementia; Cognitive function training; Long-term care insurance; Cognitive function; Older people
Citation
Age and Ageing, v.48, no.5, pp 636 - 642
Pages
7
Journal Title
Age and Ageing
Volume
48
Number
5
Start Page
636
End Page
642
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4230
DOI
10.1093/ageing/afz067
ISSN
0002-0729
1468-2834
Abstract
Objectives: despite the extensive literature on the effectiveness of cognitive training, its effectiveness has not been demonstrated within a population-based long-term care system. To provide cognitive training services to older people with mild dementia, Korea introduced a special dementia rating, as a long-term care grades, in the national long-term care insurance in July 2014. These services are only offered to those with the special dementia rating. This study evaluated the national long-term care insurance-funded cognitive function training programme for older people with mild dementia. Methods: data were derived from the Korean National Health Insurance Elderly Cohort database between 2008 and 2015. We compared changes in function between the intervention (n = 352) and control (n = 1952) groups before (2014) and after (2015) introduction of the cognitive function training programme. Difference-in-differences analysis was performed, to compare changes in each score between the intervention and control groups before and after introduction of the cognitive function training programme. Results: introduction of the cognitive function training programme was associated with significantly less cognitive function decline in the intervention group than in the control groups (beta = -3.39; standard errors [SE] = 1.14; P = 0.003). A subgroup analysis revealed that this effect increased in subjects in the youngest group, low income bracket, who had a primary caregiver, who were supported in multiple activities of daily living by the primary caregiver, or who were not living alone. Conclusions: introduction of the cognitive function training programme was associated with positive effects on cognitive function.
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