The physical environment influences neuropsychiatric symptoms and other outcomes in assisted living residents

• Published in: International journal of geriatric psychiatry 2010-10, Vol.25 (10), p.1044-1054
• Main Authors: Bicket, Mark C., Samus, Quincy M., McNabney, Mathew, Onyike, Chiadi U., Mayer, Lawrence S., Brandt, Jason, Rabins, Peter, Lyketsos, Constantine, Rosenblatt, Adam
• Format: Article
• Language: English
• Subjects: Accidental Falls - statistics & numerical data; Aged; Aged, 80 and over; Alzheimer's disease; assisted living; Assisted living facilities; Assisted Living Facilities - organization & administration; Assisted Living Facilities - standards; Behavior; Biological and medical sciences; Cognitive ability; Cohort Studies; Cross-Sectional Studies; Dementia; Dementia - psychology; Dementia disorders; Discriminant analysis; elderly; Environmental quality; Factor analysis; Female; Fundamental and applied biological sciences. Psychology; General aspects; Geriatric psychiatry; Geriatrics; Gerontology; Health Facility Environment - organization & administration; Health Facility Environment - standards; Humans; Inventories; Male; Medical sciences; Mental disorders; Neurodegenerative diseases; neuropsychiatric symptoms; Neuropsychological Tests; Nursing; physical environment; Prospective Studies; Psychiatry; Psychoanalysis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; Regression analysis; Vocalization behavior
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.2460

Objective Although the number of elderly residents living in assisted living (AL) facilities is rising, few studies have examined the AL physical environment and its impact on resident well‐being. We sought to quantify the relationship of AL physical environment with resident outcomes including neuropsychiatric symptoms (NPS), quality of life (QOL), and fall risk, and to compare the effects for demented and non‐demented residents. Methods Prospective cohort study of a stratified random sample of 326 AL residents living in 21 AL facilities. Measures included the Therapeutic Environmental Screening Scale for Nursing Homes and Residential Care (TESS‐NH/RC) to rate facilities and in‐person assessment of residents for diagnosis (and assessment of treatment) of dementia, ratings on standardized clinical, cognitive, and QOL measures. Regression models compared environmental measures with outcomes. TESS‐NH/RC is modified into a scale for rating the AL physical environment AL‐EQS. Results The AL Environmental Quality Score (AL‐EQS) was strongly negatively associated with Neuropsychiatric Inventory (NPI) total score (p