Abstract
BackgroundIn nursing homes (NH) the prevalence of dementia ranges from 50 to 84% and most residents have extensive physical-performance impairments. However, from time of admission, development of physical performance in NH residents with dementia remains unexplored.AimsTo explore the overall trend in physical performance, associated characteristics, and groups following distinct trajectories from time of admission, in NH residents with dementia.MethodsWe followed newly admitted NH residents diagnosed with dementia (N = 583) from 47 NHs across Norway for 3 years. Individual assessments were conducted biannually, and main outcome measure was the Short Physical Performance Battery (SPPB). Facility-level characteristics included unit size, staff-to-resident ratio, and quality of the physical environment (Special Care Unit Environmental Quality Scale, SCUEQS).ResultsFrom time of admission, NH residents with dementia showed a significant overall decline in physical performance. Further, we identified three distinct trajectory groups with significantly different baseline physical-performance status (“good,” “moderate,” and “poor”), differences between groups maintained and all declined across time. Younger age, good general medical health, less-severe dementia, and less musculoskeletal pain were associated with both an average higher overall trend and better baseline group-belonging. Additionally, less apathy and more psychosis were associated with a higher overall trend, and agitation was associated with poorer baseline group-belonging.ConclusionsTo prevent excessive decline in physical performance in this population, NH clinicians should focus efforts specifically on assessment of physical performance at admission and on identification and management of musculoskeletal pain and neuropsychiatric symptoms.
Highlights
MethodsIncreased life expectancy is one of humanity’s greatest triumphs
Good (GMHR) was associated with higher physical performance (SPPB) throughout the study period (p < 0.001), with association varying with time
Good general medical health (GMHR Good), less-severe dementia (CDR), and less musculoskeletal pain (MOBID-2 Part 1) at baseline were associated with higher odds of being in the Moderate (p = 0.006, p = 0.007, and p = 0.001) and Good
Summary
As the proportion of older adults continues to grow, the number of dependent older adults worldwide increases [1] This will directly influence the demand for nursing home (NH) care [1]. In NHs the prevalence of dementia ranges from 50 to 84% [1, 4] and most residents have extensive physical-performance impairments [5, 6]. In nursing homes (NH) the prevalence of dementia ranges from 50 to 84% and most residents have extensive physical-performance impairments. Aims To explore the overall trend in physical performance, associated characteristics, and groups following distinct trajectories from time of admission, in NH residents with dementia. Results From time of admission, NH residents with dementia showed a significant overall decline in physical performance. Conclusions To prevent excessive decline in physical performance in this population, NH clinicians should focus efforts on assessment of physical performance at admission and on identification and management of musculoskeletal pain and neuropsychiatric symptoms
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.