Abstract
Objective
We investigate whether older adults who were newly diagnosed with dementia (severity
unspecified) and resided in an assisted living facility that offered a dementia care
program had a lower rate of transition to a nursing home, compared to those who resided
in an assisted living facility without such a program.
Design
Population-based retrospective cohort study.
Setting and Participants
Linked, person-level health system administrative data on older adults who were newly
diagnosed with dementia and resided in an assisted living facility in Ontario, Canada,
from 2014 to 2019 (n = 977).
Methods
Access to a dementia care program in an assisted living facility (n = 57) was examined.
Multivariable Cox proportional hazards regression with robust standard errors clustered
on the assisted living facility was used to model the time to transition to a nursing
home from the new dementia diagnosis.
Results
There were 11.8 transitions to a nursing home per 100 person-years among older adults
who resided in an assisted living facility with a dementia care program, compared
with 20.5 transitions to a nursing home per 100 person-years among older adults who
resided in an assisted living facility without a dementia care program. After adjustment
for relevant characteristics at baseline, older adults who resided in an assisted
living facility with a dementia care program had a 40% lower rate of transition to
a nursing home (hazard ratio 0.60, 95% confidence interval 0.44, 0.81), compared with
those in an assisted living facility without such a program at any point during the
follow-up period.
Conclusions and Implications
The rate of transition to a nursing home was significantly lower among older adults
who resided in an assisted living facility that offered a dementia care program. These
findings support the expansion of dementia care programs in assisted living facilities.
Keywords
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Article info
Publication history
Published online: August 02, 2021
Footnotes
This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and the Ministry of Long-Term Care. Parts of this material are based on data and/or information compiled and provided by CIHI. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred.
The authors declare no conflicts of interest.
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
