PLURALITY OF PRIMARY AND SPECIALTY CARE IN OLDER ADULTS WITH DEMENTIA AND MULTIMORBIDITY - Research Findings Summary

Sep 29, 2026

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Older adults with multiple chronic conditions often need care that spans many specialties, and Alzheimer’s Disease and Related Dementias (ADRD) add further complexity requiring coordinated outpatient treatment. This retrospective cohort study analyzed electronic health records from a multi-site academic system in Chicago (2016-2024). Among 64,279 patients, 16.2% had ADRD and only 11.2% of 10,687,974 outpatient encounters were primary care. Patients’ patterns and survival differed by primary-care dominance and ADRD presence, indicating coordination gaps.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Study overview

Cohort and setting

Care classification and patient grouping

Key utilization results

Survival and implications

Innovation in Aging, 2025, Vol. 9, No. S2 1083 Abstract citation ID: igaf122.3642 PLURALITY OF PRIMARY AND SPECIALTY CARE IN OLDER ADULTS WITH DEMENTIA AND MULTIMORBIDITY Sijia Wei1, Eleanor McConnell2, Daniela Ladner3, Blade Robelly3, and Jeffrey Linder3, 1. Northwestern University, Chicago, Illinois, United States, 2. Duke University, Durham, North Carolina, United States, 3. Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States Older adults with comorbidities often require care across specialties. Those with Alzheimer’s Disease and Related Dementias (ADRD) face additional challenges that require coordinated outpatient care. However, the plurality of primary care 1084 Innovation in Aging, 2025, Vol. 9, No. S2 (PC) and specialty use among this population remains understudied. This retrospective cohort study used electronic health records from a multi-site academic health system in the Chicago metropolitan area. The cohort included older adults (≥65 years) with ≥2 chronic conditions and regular outpatient visits between 2016-2024, stratified by ADRD diagnosis. Outpatient encounters were classified into PC (internal/family medicine), ADRD specialty (geriatrics, neurology, psychiatry), or other specialty. Patients were categorized based on whether their care was PC-dominant (> mean proportion of PC encounters) and whether they accessed any ADRD specialty. Among 64,279 patients, 16.2% had ADRD. Of 10,687,974 outpatient encounters, only 11.2% were PC. Overall, 18.6% of patients never accessed PC, more often among those without ADRD (21.6%) than those with (16.8%). Among patients with any PC, the average proportion of PC encounters was 16.7%±13 .3% . Patients with ADRD had less specialty-dominant care (50.0% vs. 61.1%) . Regardless of ADRD status (with ADRD vs without), patients without PC had the lowest ADRD-specialty use (55% vs 26%), while those with specialty-dominant care had the highest (78% vs 42%) . Survival was highest among patients with PC-dominant care (57% with ADRD; 81% without ADRD) . These findings highlight distinct outpatient care patterns and potential coordination gaps among PC and specialty care that need further study, which may impact outcomes among older adults with ADRD and multimorbidity.

FAQs

What outpatient care types were compared in the study?

Outpatient encounters were classified into primary care (internal/family medicine), ADRD specialty care (geriatrics, neurology, psychiatry), or other specialty.

How common was ADRD in the cohort and how much care was primary care?

Among 64,279 patients, 16.2% had ADRD. Across 10,687,974 outpatient encounters, primary care accounted for only 11.2%.

What did the study find about survival by primary-care dominance?

Survival was highest among patients receiving primary-care dominant care, with 81% survival for those without ADRD and 57% for those with ADRD.

Sep 29, 2026

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