JAMDA
Volume 10, Issue 5 , Pages 323-329, June 2009

Correlates of Functional Dependence Among Recently Admitted Assisted Living Residents With and Without Dementia

  • Quincy M. Samus, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • Corresponding Author InformationAddress correspondence to Quincy M. Samus, PhD, Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Suite 308, Baltimore, MD 21205.
    • ,
  • Lawrence Mayer, MD, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • ,
  • Chiadi U. Onyike, MD, MHS

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • ,
  • Jason Brandt, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • The Copper Ridge Institute, Sykesville, MD
    • ,
  • Alva Baker, MD

      Affiliations

    • The Copper Ridge Institute, Sykesville, MD
    • ,
  • Matthew McNabney, MD

      Affiliations

    • Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
    • ,
  • Peter V. Rabins, MD, MPH

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • The Copper Ridge Institute, Sykesville, MD
    • ,
  • Constantine G. Lyketsos, MD, MHS

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • The Copper Ridge Institute, Sykesville, MD
    • Department of Psychiatry, Johns Hopkins Bayview, School of Medicine, Baltimore, MD
    • ,
  • Adam Rosenblatt, MD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
    • The Copper Ridge Institute, Sykesville, MD

Objectives

To 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.

Design

A cross-sectional study.

Setting

A random sample of 28 AL facilities in the Central Maryland region.

Participants

Two hundred and sixty-two AL residents assessed less than1 year after admission.

Measurements

Participants 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.

Results

The 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.

Conclusions

Recently 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.

Keywords: Disability, cognitive impairment, long-term care, assisted living

 

 This project was supported by Grant R01MH60626 from the National Institute of Mental Health (NIMH) and the National Institute on Aging (NIA).

PII: S1525-8610(09)00027-9

doi:10.1016/j.jamda.2009.01.004

JAMDA
Volume 10, Issue 5 , Pages 323-329, June 2009

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