AG 3: A COMPARATIVE COST ANALYSIS OF ALZHEIMER'S DISEASE VERSUS VASCULAR DEMENTIA

Abstract

OBJECTIVE: The Omnibus Reconciliation Act of 1987 (OBRA ‘87) requires trained clinical professionals in nursing homes to complete an assessment called the Minimum Data Set (MDS) to evaluate the functional, medical, psychosocial, and cognitive status for each resident. The objective of this pilot study is to examine the relationship between cognitive status as measured by the MDS Cognitive Performance Scale (CPS) and qualityof-life as measured by the Quality-of-Life in Late-Stage Dementia (QUALID) scale among residents of West Virginia (WV) long-term care (LTC) facilities. METHODS: A cross-sectional study was completed using a convenience sample of 339 residents from 10 LTC facilities in WV. CPS scores for residents were calculated by a consultant pharmacist from the MDS scores. Direct care assistants assessed residents’ quality-of-life using the QUALID scale, which evaluates 11 observational behaviors on a 5-point scale with scores ranging from 11 (best) to 55 (worst). Descriptive statistics and one-way ANOVAs were conducted to examine differences in quality-of-life among residents with intact cognitive function (CPS = 0), mild cognitive impairment (CI) (CPS = 1,2), moderate CI (CPS = 3,4) and severe CI (CPS = 5,6). RESULTS: The mean age for residents was 78.5 years. QUALID and CPS mean scores were 24.07 and 3.34, respectively. Mean QUALID scores for individuals with severe CI (27.1 ± 7.8) were significantly higher (p < 0.00) than for individuals with intact cognitive function (20.0 ± 7.3), mild CI (21.4 ± 7.8) and moderate CI (22.9 ± 9.2). One-way ANOVAs showed no differences for QUALID and CPS scores based on age categories and gender. CONCLUSIONS: Results of this study show that cognitive status, as indicated by CPS scores, significantly affects QUALID scores. Based on QUALID scores, LTC residents with more severe CI have significantly lower quality-oflife. Further studies are needed to determine if improved changes in QUALID scores postpone decline of cognitive status or if interventions which delay deteriorating cognitive status improve quality-of-life.