A comparison of family care infrastructure for demented elderly in inner cities and regional areas in Japan

Abstract

Background: Family members' observations of daily life are important for the diagnosis and treatment of dementia. However, elderly people are increasingly living alone, and family structures tend to differ between inner-city areas and regional areas. We aimed to compare the family caregiving infrastructure of demented elderly visiting a memory clinic.

Methods: Subjects were consecutive outpatients with dementia at the memory clinic at a university hospital in two different areas. We compared subjects' demographic data, residency status, housemates and companion status at the time of their initial visit.

Results: Patients in the inner-city area (n= 99) had more education and higher Mini-Mental State Examination scores than those in the regional area (n= 172). In both areas, the highest proportion of patients lived with their spouse. In the inner city, patients' housemates were either their spouse (34%) or their child (13%); 22% lived alone. In regional areas, patients lived with their spouse only (39%) or in their child's household (23%); 14% lived alone. At their initial consultation, inner-city patients were accompanied by a family member other than their spouse (49%), a spouse (27%), or they were alone (7%). In the regional area, patients' companions were their spouse (35%) or their spouse and other family members (18%); patients rarely arrived alone. Regression analysis showed that education, diagnosis, housemate state (child only), and companion state (alone) significantly influenced the living area.

Conclusion: Our results suggest family caregiving infrastructure of demented elderly differ between the two areas. This may reflect changes in social structure and increased awareness regarding dementia in inner-city areas.