Correlates of functional dependence among recently admitted assisted living residents with and without dementia.
Correlates of functional dependence among recently admitted assisted living residents with and without dementia.
复制标题
最近入院的患有和不患有痴呆症的辅助生活居民的功能依赖性的相关性。
DOI：
10.1016/j.jamda.2009.01.004
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发表时间：
2009
影响因子：
7.6
通讯作者：
Rosenblatt,Adam
中科院分区：
文献类型：
--
作者：
Samus,QuincyM;Mayer,Lawrence;Onyike,ChiadiU;Brandt,Jason;Baker,Alva;McNabney,Matthew;Rabins,PeterV;Lyketsos,ConstantineG;Rosenblatt,Adam
目的描述和对比最近入院的有痴呆和无痴呆的AL患者的功能依赖(FD)水平，并评估认知、行为、医学和社会因素在每个组中对FD的不同贡献。设计横断面研究。随机抽取马里兰州中部地区28家AL机构的样本。部分评估入院后不到1年的262名AL患者。对受试者进行全面的面对面痴呆评估。还评估了认知、行为、医学和社会因素。结果59%的痴呆症患者FD水平较高(P<；.001)，除活动能力(P<；.653)外，更有可能在所有评估的任务特定ADL领域(P<；.001)需要帮助。在多变量模型中，全球认知、医疗健康状况和糖尿病的存在解释了痴呆组FD变异的43%。在非痴呆者中，25%的FD变异可以用抑郁、神经精神症状和全球认知来解释。结论最近承认AL患者有相当程度的FD。患有痴呆症的居民的FD比没有痴呆的居民更高，认知、心理健康和医学变量与FD的关联因痴呆状态的不同而不同。未来的研究应该检查这些维度是如何纵向影响FD的，以及它们是否可以作为干预和改善护理质量倡议的目标。
OBJECTIVESTo describe and contrast functional dependency (FD) levels among recently admitted AL residents with and without dementia and to assess the differential contribution of cognitive, behavioral, medical, and social factors on FD within each group.DESIGNA cross-sectional study.SETTINGA random sample of 28 AL facilities in the Central Maryland region.PARTICIPANTSTwo hundred and sixty-two AL residents assessed less than1 year after admission.MEASUREMENTSParticipants were given comprehensive in-person dementia assessments. Cognitive, behavioral, medical, and social factors were also assessed. FD was operationalized as impairment in activities of daily living.RESULTSThe 59% of residents with dementia had higher levels of FD (P < .001) and were more likely to require assistance in all assessed task-specific ADL domains (P < .001) except mobility (P = .653). In multivariate models, global cognition, medical health status, and presence of diabetes explained 43% of the variance in FD in the dementia group. Twenty-five percent of the variance in FD was explained by depression, neuropsychiatric symptoms, and global cognition in those without dementia.CONCLUSIONSRecently admitted AL residents have substantial levels of FD. FD is higher among residents with dementia compared with those without and the association of cognitive, mental health, and medical variables with FD differ as a function of dementia status. Future research should examine how these dimensions affect FD longitudinally and whether they may serve as targets for interventions and quality of care improvement initiatives.