TY - JOUR
T1 - Predictors of functional impairment in residents of assisted-living facilities
T2 - The Maryland assisted living study
AU - Burdick, Daniel J.
AU - Rosenblatt, Adam
AU - Samus, Quincy M.
AU - Steele, Cynthia
AU - Baker, Alva
AU - Harper, Michael
AU - Mayer, Lawrence
AU - Brandt, Jason
AU - Rabins, Peter
AU - Lyketsos, Constantine G.
N1 - Funding Information:
ACKNOWLEDGMENTS This study was supported by a John A. Hartford Scholar grant from the American Federation for Aging Research, by a grant from the Office of the Dean of Students at the Johns Hopkins University School of Medicine, and by grant RO1 MH 60626 from the National Institute of Mental Health. We are grateful to the study participants and their families for their participation, to the management and staff of the participating assisted living facilities, and to the staff at Copper Ridge for their dedication and assistance in the development of the MD-AL study.
PY - 2005/2
Y1 - 2005/2
N2 - Background. Assisted living is a popular residential option for older individuals, yet little research has been done on people choosing this option. This study examines predictors of functional impairment in assisted living residents in the domains of cognition, mood, and health. Methods. An experienced team of neuropsychiatrists, nurses, and technicians using a number of cognitive, behavioral, health, and functional status tests and a cross-sectional study design assessed 198 residents of 22 assisted living facilities in Maryland. Data from these evaluations were used in univariate and multiple regression models to identify predictors of functional impairment, operationalized as the sum of the scores on two scales, one measuring impairment in basic activities of daily living and one measuring impairment in instrumental activities of daily living. Results. Greater cognitive impairment, worse depression, and worse medical health were significant independent predictors of functional impairment, together explaining a sizeable portion of the variance (adjusted R2 = 0.434). None of the demographic variables examined individually, including age and education, was predictive of functional impairment. In an analysis of specific cognitive domains, executive dysfunction, impairment of visuospatial skills, and amnesia were significant predictors of impairment, whereas inattention was not. Conclusion. Executive dysfunction, apraxia, memory impairment, depression, and general medical health are all significant predictors of functional impairment in assisted living residents, with executive dysfunction being the strongest. These results may be instrumental in developing a more efficient model of care for residents of assisted living facilities, one based on having accurate predictive models of degree of impairment.
AB - Background. Assisted living is a popular residential option for older individuals, yet little research has been done on people choosing this option. This study examines predictors of functional impairment in assisted living residents in the domains of cognition, mood, and health. Methods. An experienced team of neuropsychiatrists, nurses, and technicians using a number of cognitive, behavioral, health, and functional status tests and a cross-sectional study design assessed 198 residents of 22 assisted living facilities in Maryland. Data from these evaluations were used in univariate and multiple regression models to identify predictors of functional impairment, operationalized as the sum of the scores on two scales, one measuring impairment in basic activities of daily living and one measuring impairment in instrumental activities of daily living. Results. Greater cognitive impairment, worse depression, and worse medical health were significant independent predictors of functional impairment, together explaining a sizeable portion of the variance (adjusted R2 = 0.434). None of the demographic variables examined individually, including age and education, was predictive of functional impairment. In an analysis of specific cognitive domains, executive dysfunction, impairment of visuospatial skills, and amnesia were significant predictors of impairment, whereas inattention was not. Conclusion. Executive dysfunction, apraxia, memory impairment, depression, and general medical health are all significant predictors of functional impairment in assisted living residents, with executive dysfunction being the strongest. These results may be instrumental in developing a more efficient model of care for residents of assisted living facilities, one based on having accurate predictive models of degree of impairment.
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U2 - 10.1093/gerona/60.2.258
DO - 10.1093/gerona/60.2.258
M3 - Article
C2 - 15814872
AN - SCOPUS:20944435519
SN - 1079-5006
VL - 60
SP - 258
EP - 264
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 2
ER -