Transition to nursing home from assisted living is not associated with dementia or dementia-related problem behaviors

Paul B. Rosenberg; Michelle M. Mielke; Quincy M. Samus; Adam Rosenblatt; Alva Baker; Jason Brandt; Peter V. Rabins; Constantine G. Lyketsos

doi:10.1016/j.jamda.2005.06.003

Transition to nursing home from assisted living is not associated with dementia or dementia-related problem behaviors

Paul B. Rosenberg, Michelle M. Mielke, Quincy M. Samus, Adam Rosenblatt, Alva Baker, Jason Brandt, Peter V. Rabins, Constantine G. Lyketsos

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Objectives: To examine risk factors for transition from assisted living (AL) care to skilled nursing facility (SNF) care in a random sample of adults residing in AL. Design: Baseline clinical evaluation and telephone follow-up at 6-month intervals for up to 36 months. Setting: AL facilities in central Maryland. Participants: There were 198 participants randomly sampled from AL facilities stratified by facility size. Measurements: Consensus diagnoses by multidisciplinary geriatric psychiatry team as well as a broad range of neuropsychiatric and functional scales including Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, Mini-Mental State Exam, and Alzheimer's Disease Related Quality of Life Scale, as well as cognitive tests. Possible risk factors for transition to SNF were assessed in Cox proportional-hazards multivariate regression methods, using a P value less than .05 for statistical significance. Results: Twenty-nine participants transitioned to SNF care. Mean AL survival time from baseline evaluation was 0.8 (SD 0.6) years for residents transitioned to SNF and 1.4 (SD 0.7) years for residents remaining in AL at follow-up. Risk factors for transition to SNF included declining health, chronic pain, appetite changes, and being widowed, while insomnia was protective against transition to SNF. Surprisingly, dementia and neuropsychiatric symptoms did not increase risk of transition to SNF. Conclusion: Survival time in AL is determined by factors similar to those operating on community-dwelling elderly, but dementia and neuropsychiatric symptoms do not alter survival time.

Original language	English (US)
Pages (from-to)	73-78
Number of pages	6
Journal	Journal of the American Medical Directors Association
Volume	7
Issue number	2
DOIs	https://doi.org/10.1016/j.jamda.2005.06.003
State	Published - Feb 2006

Keywords

Assisted living
Chronic pain
Dementia
Insomnia
Nursing home
Survival analysis

ASJC Scopus subject areas

General Nursing
Health Policy
Geriatrics and Gerontology

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10.1016/j.jamda.2005.06.003

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@article{c9175d3037ef416f9ad1899d34b7a04a,

title = "Transition to nursing home from assisted living is not associated with dementia or dementia-related problem behaviors",

abstract = "Objectives: To examine risk factors for transition from assisted living (AL) care to skilled nursing facility (SNF) care in a random sample of adults residing in AL. Design: Baseline clinical evaluation and telephone follow-up at 6-month intervals for up to 36 months. Setting: AL facilities in central Maryland. Participants: There were 198 participants randomly sampled from AL facilities stratified by facility size. Measurements: Consensus diagnoses by multidisciplinary geriatric psychiatry team as well as a broad range of neuropsychiatric and functional scales including Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, Mini-Mental State Exam, and Alzheimer's Disease Related Quality of Life Scale, as well as cognitive tests. Possible risk factors for transition to SNF were assessed in Cox proportional-hazards multivariate regression methods, using a P value less than .05 for statistical significance. Results: Twenty-nine participants transitioned to SNF care. Mean AL survival time from baseline evaluation was 0.8 (SD 0.6) years for residents transitioned to SNF and 1.4 (SD 0.7) years for residents remaining in AL at follow-up. Risk factors for transition to SNF included declining health, chronic pain, appetite changes, and being widowed, while insomnia was protective against transition to SNF. Surprisingly, dementia and neuropsychiatric symptoms did not increase risk of transition to SNF. Conclusion: Survival time in AL is determined by factors similar to those operating on community-dwelling elderly, but dementia and neuropsychiatric symptoms do not alter survival time.",

keywords = "Assisted living, Chronic pain, Dementia, Insomnia, Nursing home, Survival analysis",

author = "Rosenberg, {Paul B.} and Mielke, {Michelle M.} and Samus, {Quincy M.} and Adam Rosenblatt and Alva Baker and Jason Brandt and Rabins, {Peter V.} and Lyketsos, {Constantine G.}",

note = "Funding Information: This study was supported by grants R01 MH 60626 and 1U01 MH 66136 from the National Institutes of Mental Health. We are grateful to Vani Rao, MD, and Jennifer Spiro, MS, for their analysis of sleep variables, 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 study.",

year = "2006",

month = feb,

doi = "10.1016/j.jamda.2005.06.003",

language = "English (US)",

volume = "7",

pages = "73--78",

journal = "Journal of the American Medical Directors Association",

issn = "1525-8610",

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TY - JOUR

T1 - Transition to nursing home from assisted living is not associated with dementia or dementia-related problem behaviors

AU - Rosenberg, Paul B.

AU - Mielke, Michelle M.

AU - Samus, Quincy M.

AU - Rosenblatt, Adam

AU - Baker, Alva

AU - Brandt, Jason

AU - Rabins, Peter V.

AU - Lyketsos, Constantine G.

N1 - Funding Information: This study was supported by grants R01 MH 60626 and 1U01 MH 66136 from the National Institutes of Mental Health. We are grateful to Vani Rao, MD, and Jennifer Spiro, MS, for their analysis of sleep variables, 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 study.

PY - 2006/2

Y1 - 2006/2

N2 - Objectives: To examine risk factors for transition from assisted living (AL) care to skilled nursing facility (SNF) care in a random sample of adults residing in AL. Design: Baseline clinical evaluation and telephone follow-up at 6-month intervals for up to 36 months. Setting: AL facilities in central Maryland. Participants: There were 198 participants randomly sampled from AL facilities stratified by facility size. Measurements: Consensus diagnoses by multidisciplinary geriatric psychiatry team as well as a broad range of neuropsychiatric and functional scales including Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, Mini-Mental State Exam, and Alzheimer's Disease Related Quality of Life Scale, as well as cognitive tests. Possible risk factors for transition to SNF were assessed in Cox proportional-hazards multivariate regression methods, using a P value less than .05 for statistical significance. Results: Twenty-nine participants transitioned to SNF care. Mean AL survival time from baseline evaluation was 0.8 (SD 0.6) years for residents transitioned to SNF and 1.4 (SD 0.7) years for residents remaining in AL at follow-up. Risk factors for transition to SNF included declining health, chronic pain, appetite changes, and being widowed, while insomnia was protective against transition to SNF. Surprisingly, dementia and neuropsychiatric symptoms did not increase risk of transition to SNF. Conclusion: Survival time in AL is determined by factors similar to those operating on community-dwelling elderly, but dementia and neuropsychiatric symptoms do not alter survival time.

AB - Objectives: To examine risk factors for transition from assisted living (AL) care to skilled nursing facility (SNF) care in a random sample of adults residing in AL. Design: Baseline clinical evaluation and telephone follow-up at 6-month intervals for up to 36 months. Setting: AL facilities in central Maryland. Participants: There were 198 participants randomly sampled from AL facilities stratified by facility size. Measurements: Consensus diagnoses by multidisciplinary geriatric psychiatry team as well as a broad range of neuropsychiatric and functional scales including Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, Mini-Mental State Exam, and Alzheimer's Disease Related Quality of Life Scale, as well as cognitive tests. Possible risk factors for transition to SNF were assessed in Cox proportional-hazards multivariate regression methods, using a P value less than .05 for statistical significance. Results: Twenty-nine participants transitioned to SNF care. Mean AL survival time from baseline evaluation was 0.8 (SD 0.6) years for residents transitioned to SNF and 1.4 (SD 0.7) years for residents remaining in AL at follow-up. Risk factors for transition to SNF included declining health, chronic pain, appetite changes, and being widowed, while insomnia was protective against transition to SNF. Surprisingly, dementia and neuropsychiatric symptoms did not increase risk of transition to SNF. Conclusion: Survival time in AL is determined by factors similar to those operating on community-dwelling elderly, but dementia and neuropsychiatric symptoms do not alter survival time.

KW - Assisted living

KW - Chronic pain

KW - Dementia

KW - Insomnia

KW - Nursing home

KW - Survival analysis

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Transition to nursing home from assisted living is not associated with dementia or dementia-related problem behaviors

Abstract

Keywords

ASJC Scopus subject areas

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