Advanced cognitive impairment among older nursing home residents

• Published in: BMC geriatrics 2021-06, Vol.21 (1), p.382-382, Article 382
• Main Authors: Gracner, Tadeja, Stone, Patricia W, Agarwal, Mansi, Sorbero, Mark, Mitchell, Susan L, Dick, Andrew W
• Format: Article
• Language: English
• Subjects: Activities of daily living; Advanced cognitive impairment; Alzheimer Disease - diagnosis; Alzheimer Disease - therapy; Alzheimer's disease; Body weight loss; Chronic obstructive pulmonary disease; Cognition disorders in old age; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - epidemiology; Congestive heart failure; Dementia; Dementia disorders; Demographics; Demography; Diabetes; Diabetes mellitus; End-of-Life; Female; Geriatrics; Heart failure; Humans; Hypertension; Illnesses; Lung diseases; Mortality; Neurodegenerative diseases; Nursing care; Nursing home patients; Nursing Homes; Obstructive lung disease; Older people; Psychological aspects; Pulmonary Disease, Chronic Obstructive; Retrospective Studies; Risk factors; Statistics; Stroke; Survival; Urinary tract
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-021-02336-1

Though work has been done studying nursing home (NH) residents with either advanced Alzheimer's disease (AD) or Alzheimer's disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011-2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p