The Impact of Home Health Physical Therapy on Medicare Beneficiaries With a Primary Diagnosis of Dementia

J Am Geriatr Soc. 2020 Apr;68(4):867-871. doi: 10.1111/jgs.16307. Epub 2020 Jan 13.

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. J Am Geriatr Soc 68:867-871, 2020.

Keywords: dementia; home health; physical function; physical therapy; propensity score.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Dementia / therapy*
  • Fee-for-Service Plans
  • Female
  • Geriatric Assessment
  • Home Care Services / organization & administration*
  • Humans
  • Male
  • Medicare
  • Physical Therapy Modalities / statistics & numerical data*
  • Treatment Outcome
  • United States