Physical restraint use and cognitive decline among nursing home residents

Lynda C. Burton, Pearl S. German, Barry W. Rovner, Larry J. Brant

Research output: Contribution to journalArticle

Abstract

Objective This study investigated the association between physical restraint use and decline in cognition. Design Cohort analytic study describing changes in resident characteristics. Setting Eight nursing homes, both urban and suburban, operated by a proprietary corporation in a large metropolitan area. Participants 437 nursing home admissions, with 201 remaining at 1 year. Main Outcome Measures Cognitive status was measured by geropsychiatrists, using the Folstein Mini-Mental State Exam, during a psychiatric evaluation of the resident. Daily restraint use was documented from nursing orders. Observations were made at 2 weeks, 10 weeks, and 1 year. Results Restraint use alone and in combination with neuroleptic use was associated with poor cognition. Other variables associated with poor cognitive scores were: ADL impairment, poor adaptive behavior, and longer time in the nursing home. The use of neuroleptics alone was not significant. Variables which were associated with good cognitive status were: being non-ambulatory but without dementia and having strong social support. Conclusions These findings raise the possibility that restraint use may contribute to cognitive impairment, specifically among residents who have moderate to no cognitive impairment at admission; however, the findings do not exclude an alternative explanation that residents undergoing cognitive decline are more likely to be put in restraints. Further research is needed to understand whether factors which can be manipulated contribute to cognitive decline.

Original languageEnglish (US)
Pages (from-to)811-816
Number of pages6
JournalJournal of the American Geriatrics Society
Volume40
Issue number8
DOIs
StatePublished - Aug 1 1992

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Physical Restraint
Nursing Homes
Cognition
Antipsychotic Agents
Psychological Adaptation
Activities of Daily Living
Social Support
Psychiatry
Dementia
Nursing
Cohort Studies
Outcome Assessment (Health Care)
Cognitive Dysfunction
Research

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Physical restraint use and cognitive decline among nursing home residents. / Burton, Lynda C.; German, Pearl S.; Rovner, Barry W.; Brant, Larry J.

In: Journal of the American Geriatrics Society, Vol. 40, No. 8, 01.08.1992, p. 811-816.

Research output: Contribution to journalArticle

Burton, Lynda C. ; German, Pearl S. ; Rovner, Barry W. ; Brant, Larry J. / Physical restraint use and cognitive decline among nursing home residents. In: Journal of the American Geriatrics Society. 1992 ; Vol. 40, No. 8. pp. 811-816.
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