Older Adults With Dementia With Care Partners Have Greater Patient Portal Use

Older adults with and without dementia are similarly likely to be registered for a patient portal, however, those with dementia are 3 times more likely to have a care partner actively engaged in messaging, according to study findings published in JAMA Internal Medicine.

Navigating health care has increasingly relied on the use of electronic messaging through patient portals; however, little is known about the portal interactions of patients with dementia and their care partners.

Researchers conducted a cohort study at a large academic health system to assess patient portal activity among those aged 65 years and older with 2 or more evaluation and management visits over any 24-month period between 2017 and 2022. A portal activity metric involving the ratio of number of portal sessions to number of clinical encounters was used to measure portal activity among patients and their care partners according to dementia diagnosis. Portal activity was also assessed in older adults with recently diagnosed dementia, with portal use measured each month for the 12 months prior to and following diagnosis.

The study cohort consisted of 49,382 patients (57.3% women), with 6.4% having a diagnosis of dementia. Patients with and without a dementia were similarly likely to be registered for the patient portal; however, those with dementia were more likely to have a registered care partner with shared access to their portal account compared with those without a diagnosis of dementia.

Portal activity differed between patients with vs without dementia. Those with a dementia diagnosis had significantly lower portal activity metric relative to those without dementia (3.88 vs 5.35; P <.001). Further, more portal messages came from registered care partners of patients diagnosed with dementia compared with those without a diagnosis (19.50 vs 13.85; P =.03). Among patients with a dementia diagnosis, portal activity metric was higher in the 12 months following the diagnosis relative to the 12 months preceding the diagnosis (3.34 vs 2.02).

The researchers noted that while older adults with and without diagnosed dementia were similarly likely to be registered for the patient portal, those with a diagnosis of dementia were more likely to have a registered care partner interact with the portal on their behalf.

“[T]he results highlight the need to better support all patients, including those who desire or rely on care partners, through consumer-oriented health information technologies,” the researchers concluded.

These results highlight the important contribution of registered care partner support and the potential need to enhance shared-access or proxy portal registration for care partners of patients with dementia.

A limitation of the study was the use of electronic medical records, which may have missing or inaccurate data.