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

References 

  1. Mollica R. State assisted living policy, 2002. Available at: http://www.nashp.org/Files/ltc_15_AL_2002.pdf. Accessed January 19, 2007.
  2. Hawes C, Phillips C. Defining quality in assisted living: comparing apples, oranges, and broccoli. Gerontologist. 2007;47:40–50
  3. Hawes C. Introduction. In:  Zimmerman S,  Sloane PD,  Eckert JK editor. Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly. Baltimore, MD: The Johns Hopkins University Press; 2001;1–6
  4. Nolin M, Mollica R. Residential care/assisted living in the changing health care environment. In:  Zimmerman S,  Sloane PD,  Eckert JK editor. Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly. Baltimore, MD: The Johns Hopkins University Press; 2001;34–52
  5. Spillman BC, Black KJ. The Size and Characteristics of the Residential Care Population: Evidence from Three National Surveys. U.S. Department of Health and Human Services; 2006;Available at: http://aspe.hhs.gov/daltcp/reports/2006/3natlsur.com. Accessed February 10, 2008
  6. Morgan LA, Gruber-Baldini A, Magaziner J. Resident characteristics. In:  Zimmerman S,  Sloane PD,  Eckert JK editor. Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly. Baltimore, MD: The Johns Hopkins University Press; 2001;144–172
  7. Promatura Group . LLC. NIC national supply estimate of seniors housing & care properties. Annapolis, MD: National Investment Center for the Seniors Housing and Care Industries; 2000;
  8. Rosenblatt A, Samus QM, Steele CD, et al. The Maryland assisted living study: Prevalence, recognition, and treatment of dementia and other psychiatric disorders in the assisted living population of central Maryland. J Am Geriatr Soc. 2004;52:1618–1625
  9. National Center for Assisted Living. Facts and Trends: The Assisted Living Sourcebook. Washington DC: National Center for Assisted living 2001.
  10. Burdick DJ, Rosenblatt A, Samus QM, et al. Predictors of functional impairment in residents of assisted-living facilities: The Maryland assisted living study. J Gerontol A Biol Sci Med Sci. 2005;60:258–264
  11. Mollica R. State assisted living policy: 2000. Portland, ME: National Academy for State Health Policy; 2000;
  12. Arling G, Williams A. Cognitive impairment and resource use of nursing home residents: A structural equation model. Med Care. 2003;41:802–812
  13. Bruce DG, Paley GA, Nichols P, et al. Physical disability contributes to caregiver stress in dementia caregivers. J Gerontol A Biol Sci Med Sci. 2005;60:345–349
  14. Samus QM, Rosenblatt A, Steele C, et al. The association of neuropsychiatric symptoms and environment with quality of life in assisted living residents with dementia. Gerontologist. 2005;45:19–26
  15. Lyketsos C, Samus QM, Baker A, et al. The impact of dementia and treatment of dementia on time to discharge from assisted living facilities: The Maryland Assisted Living Study. J Am Geriatr Soc. 2007;5:1031–1037
  16. Fried LP. Guralnik JM. Disability in older adults: Evidence regarding significance, etiology, and risk. J Am Geriatr Soc. 1997;45:92–100
  17. World Health Organization . The International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2002;
  18. Aguero-Torres H, Fratiglioni L, Guo Z, et al. Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population-based study. Am J Public Health. 1998;88:1452–1456
  19. Dodge HH, Kadowaki T, Hayakawa T, et al. Cognitive impairment as a strong predictor of incident disability in specific ADL-IADL tasks among community-dwelling elders: The Azuchi study. Gerontologist. 2005;45:222–230
  20. Sauvaget C, Yamada M, Fujiwara S, et al. Dementia as a predictor of functional disability: A four-year follow-up study. Gerontology. 2002;48:226–233
  21. Boyle PA, Malloy PF, Salloway S, et al. Executive dysfunction and apathy predict functional impairment in Alzheimer disease. Am J Geriatr Psychiatry. 2003;11:214–221
  22. Fried L, Ettinger W, Lind B, et al. Physical disability in older adults: A physiological approach. Cardiovascular health study research group. J Clin Epidemiol. 1994;47:747–760
  23. Cahn-Weiner DA, Malloy PF, Boyle PA, et al. Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. Clin Neuropsychol. 2000;14:187
  24. Boyd CM, Xue Q-L, Simpson CF, et al. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005;118:1225
  25. Gill TM, Guo Z, Allore HG. The epidemiology of bathing disability in older persons. J Am Geriatr Soc. 2006;54:1524–1530
  26. Mendes de Leon CF, Glass TA, Berkman LF. Social engagement and disability in a community population of older adults: The New Haven EPESE. Am J Epidemiol. 2003;157:633–642
  27. Boult C, Kane R, Louis T, et al. Chronic conditions that lead to functional limitation in the elderly. J Gerontol. 1994;49:M28–M36
  28. Schultz SK, Ellingrod VL, Moser DJ, et al. The influence of cognitive impairment and psychiatric symptoms on daily functioning in nursing facilities: A longitudinal study. Ann Clin Psychiatry. 2002;14:209
  29. Schultz SK, Ellingrod VL, Turvey C, et al. The influence of cognitive impairment and behavioral dysregulation on daily functioning in the nursing home setting. Am J Psychiatry. 2003;160:582–584
  30. American Psychiatric Association . (DSM-IV-TR) Diagnostic and statistical manual of mental disorders. 4th ed.. Washington, DC: American Psychiatric Press, Inc; 2000;text revision
  31. Wilkinson I, Graham-White J. Psychogeriatric dependency rating scales (PGDRS): A method of assessment for use by nurses. Br J Psychiatry. 1980;137:558–565
  32. Folstein M, Folstein S, McHugh P. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res. 1979;12:189–198
  33. Reitan R. Trail making test: Manual for administration and scoring. Tucson: Reitan Neuropsychological Laboratory; 1958;
  34. Alexopoulos GS, Abrams RC, Young RC, et al. Cornell scale for depression in dementia. Biol Psychiatry. 1988;23:271
  35. Cummings JL. The neuropsychiatric inventory: Assessing psychopathology in dementia patients. Neurology. 1997;48:S10–S16
  36. Lyketsos C, Galik E, Steele C, et al. The general medical health rating: A bedside global rating of medical comorbidity in patients with dementia. J Am Geriatr Soc. 1999;47:487–491
  37. Samus QM, Rosenblatt A, Onyike C, et al. Correlates of caregiver-rated quality of life in assisted living: The Maryland assisted living study. J Gerontol B Psychol Sci Soc Sci. 2006;61:P311–P314
  38. Appelbaum PS, Bonnie RJ, Karlawish JH. The capacity to vote of persons with Alzheimer's disease. Am J Psychiatry. 2005;162:2094–2100
  39. Fitz A, Teri L. Depression, cognition, and functional ability in patients with Alzheimer's disease. J Am Geriatr Soc. 1994;42:186–191
  40. Arvanitakis Z, Wilson RS, Bienias JL, et al. Diabetes mellitus and risk of Alzheimer disease and decline of cognitive function. Arch Neurol. 2004;61:661–666
  41. McGuire LC, Ford ES, Ajani UA. The impact of cognitive functioning on mortality and the development of functional disability in older adults with diabetes: The second longitudinal study on aging. BMC Geriatrics. 2006;6:8
  42. Yang Y, George L. Functional disability, disability transitions, and depressive symptoms in late life. J Aging Health. 2005;17:263–292
  43. Dunlop DD, Manheim LM, Sohn M-W, et al. Incidence of functional limitation in older adults: The impact of gender, race, and chronic conditions. Arch Phys Med Rehab. 2002;83:964–971
  44. Hawes C, Phillips CD, Rose M. High Service or High Privacy Assisted Living Facilities, Their Residents and Staff: Results from a National Survey. Washington, DC: Myers Research Institute; 2000;

 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