Course of activities of daily living in nursing home residents with dementia from admission to 36-month follow-up
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RESEARCH ARTICLE
Open Access
Course of activities of daily living in nursing home residents with dementia from admission to 36-month follow-up Reidun Haarr Johansen1*† , Karoline Olsen1†, Sverre Bergh2,3,4, Jūratė Šaltytė Benth5,6,7, Geir Selbæk2,8,9 and Anne-Sofie Helvik2,10
Abstract Background: Dementia is affecting both the person with the disease and the family members. It is associated with nursing home admission, and a reduced ability to perform personal activities of daily living (P-ADL). The aim of this study was to examine the association between the severity of dementia and P-ADL function, and to study if additional factors such as neuropsychiatric symptoms, type of nursing home unit, and use of medication were associated with P-ADL function. Methods: A total of 582 nursing home residents with dementia, included at admission to the nursing home, were followed with biannual assessments for 36 months. P-ADL was assessed using the Physical Self-Maintenance scale, and severity of dementia was measured with the Clinical Dementia Rating scale. In addition, neuropsychiatric symptoms, general physical health, and use of medications were assessed at the same time points. Demographic information was collected at baseline. Linear mixed models were estimated. Results: There was a significant (p < 0.05) non-linear decline in P-ADL function over time in analysis not adjusting for any characteristics. More severe dementia at baseline and at the follow-up assessments was associated with lower P-ADL function (p < 0.001), with the association being stable over time. A higher level of neuropsychiatric symptoms, not using anti-dementia medication, being in a regular care unit as compared to a special care unit and having poor/ fair general physical health as compared to good/excellent, were associated with a lower P-ADL function. Conclusion: The association between more severe dementia and lower P-ADL function was stable over a 36-month follow-up period of nursing home residents with dementia. Health care planners and clinicians should be aware of this when planning for and treating nursing home residents. Keywords: Cognitive impairment, Functional impairment, Behavioural symptoms, Elderly, Home for the aged, Long term care, Functional decline, Psychotropic medication, PSMS, CDR
* Correspondence: [email protected] † Reidun Haarr Johansen and Karoline Olsen contributed equally to this work. 1 Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third
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