Neurological Conditions: Causes and Prevalence
Although the language of the bill includes a potentially wide range of neurological conditions and diseases, it makes specific mention of MS, Parkinson’s disease, and TBI.
MS is a chronic disease of the nervous system that affects communications between the brain the rest of the body. The cause(s) of MS are still unknown, but 12,000 new cases are diagnosed in the United States every year, typically in adults between the ages of 20 and 40.
Parkinson’s disease is a nervous system disease characterized by the inability to control the body’s movements. Over 60,000 diagnoses are made in the United States per year. Parkinson’s usually begins around age 60, but 5-10% of diagnoses occur before this age.
TBI refers to any of a number of brain injuries that results from a violent injury to the head, such as a blow, jolt, or penetration of the skull. The mildest form of TBI is a concussion; severe cases can have long-term effects on physical and mental functioning. In 2010, 2.5 million hospital visits were a result of a TBI. Military service members, particularly those in combat situations, are at increased risk of TBI: between 10,000 and 30,000 diagnoses each year can be attributed to military personnel alone.
These conditions vary in symptoms and severity but are generally chronic, irreversible, and require similar types of care. They are also more common in younger adults than other types of neurological conditions like Alzheimer’s or dementia that typically affect older adults. Standards of care for these conditions are well-established. The National Multiple Sclerosis Society, for example, has published a report outlining best practices for the care of MS. Similar documents exist for Parkinson’s Disease and TBI.
The Role of Adult Day Care
The benefits of ADC among older adults are well-documented. ADC is a relatively low-cost service compared to hospital, nursing home, and emergency care. Coupled with the fact that adults participating in ADC programs are also less likely to use hospital and emergency medical services, these programs deliver economic benefits. They have also been shown to reduce psychological distress and depression and improve patients’ well-being, especially in ADC programs that focus on social engagement with others. Research on ADC benefits to caregiver well-being have shown mixed results, but most studies show some form of improvement. Benefits may include reduced depression and stress, lower perceived burden, and better sleep.
Despite these successes, there are several challenges associated with ADC programs. Dropout rates are high within the first few months of care. There are also racial and socioeconomic disparities in usage rates, due to discrepancies in access to these resources. Furthermore, almost all scholarly research on ADC programs focuses on elderly adults. Little research exists on ADC for younger adults with neurological conditions.