TY - JOUR
T1 - Correlates of Functional Dependence Among Recently Admitted Assisted Living Residents With and Without Dementia
AU - Samus, Quincy M.
AU - Mayer, Lawrence
AU - Onyike, Chiadi U.
AU - Brandt, Jason
AU - Baker, Alva
AU - McNabney, Matthew
AU - Rabins, Peter V.
AU - Lyketsos, Constantine G.
AU - Rosenblatt, Adam
N1 - Funding Information:
This project was supported by Grant R01MH60626 from the National Institute of Mental Health (NIMH) and the National Institute on Aging (NIA).
PY - 2009/6
Y1 - 2009/6
N2 - Objectives: To describe and contrast functional dependency (FD) levels among recently admitted AL residents with and without dementia and to assess the differential contribution of cognitive, behavioral, medical, and social factors on FD within each group. Design: A cross-sectional study. Setting: A random sample of 28 AL facilities in the Central Maryland region. Participants: Two hundred and sixty-two AL residents assessed less than1 year after admission. Measurements: Participants were given comprehensive in-person dementia assessments. Cognitive, behavioral, medical, and social factors were also assessed. FD was operationalized as impairment in activities of daily living. Results: The 59% of residents with dementia had higher levels of FD (P < .001) and were more likely to require assistance in all assessed task-specific ADL domains (P < .001) except mobility (P = .653). In multivariate models, global cognition, medical health status, and presence of diabetes explained 43% of the variance in FD in the dementia group. Twenty-five percent of the variance in FD was explained by depression, neuropsychiatric symptoms, and global cognition in those without dementia. Conclusions: Recently admitted AL residents have substantial levels of FD. FD is higher among residents with dementia compared with those without and the association of cognitive, mental health, and medical variables with FD differ as a function of dementia status. Future research should examine how these dimensions affect FD longitudinally and whether they may serve as targets for interventions and quality of care improvement initiatives.
AB - Objectives: To describe and contrast functional dependency (FD) levels among recently admitted AL residents with and without dementia and to assess the differential contribution of cognitive, behavioral, medical, and social factors on FD within each group. Design: A cross-sectional study. Setting: A random sample of 28 AL facilities in the Central Maryland region. Participants: Two hundred and sixty-two AL residents assessed less than1 year after admission. Measurements: Participants were given comprehensive in-person dementia assessments. Cognitive, behavioral, medical, and social factors were also assessed. FD was operationalized as impairment in activities of daily living. Results: The 59% of residents with dementia had higher levels of FD (P < .001) and were more likely to require assistance in all assessed task-specific ADL domains (P < .001) except mobility (P = .653). In multivariate models, global cognition, medical health status, and presence of diabetes explained 43% of the variance in FD in the dementia group. Twenty-five percent of the variance in FD was explained by depression, neuropsychiatric symptoms, and global cognition in those without dementia. Conclusions: Recently admitted AL residents have substantial levels of FD. FD is higher among residents with dementia compared with those without and the association of cognitive, mental health, and medical variables with FD differ as a function of dementia status. Future research should examine how these dimensions affect FD longitudinally and whether they may serve as targets for interventions and quality of care improvement initiatives.
KW - Disability
KW - assisted living
KW - cognitive impairment
KW - long-term care
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U2 - 10.1016/j.jamda.2009.01.004
DO - 10.1016/j.jamda.2009.01.004
M3 - Article
C2 - 19497544
AN - SCOPUS:66049110291
SN - 1525-8610
VL - 10
SP - 323
EP - 329
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 5
ER -