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Effect of Dementia and Treatment of Dementia on Time to Discharge from Assisted Living Facilities: The Maryland Assisted Living Study
Author(s) -
Lyketsos Constantine G.,
Samus Quincy M.,
Baker Alva,
McNabney Mathew,
Onyike Chiadi U.,
Mayer Lawrence S.,
Brandt Jason,
Rabins Peter,
Rosenblatt Adam
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01225.x
Subject(s) - dementia , medicine , residence , gerontology , comorbidity , cohort study , cohort , quality of life (healthcare) , prospective cohort study , physical therapy , psychiatry , demography , disease , nursing , sociology
OBJECTIVES: To estimate the association between dementia and time to discharge from individual assisted living (AL) facilities and examine, in residents with dementia, factors associated with shorter duration of residence in individual AL facilities. DESIGN: Prospective cohort study. SETTING: Twenty‐two AL facilities in central Maryland. PARTICIPANTS: Stratified random sample of 198 AL residents followed for a median of 18 months. MEASUREMENTS: Detailed assessments to diagnose dementia; assess treatment of dementia; and rate clinical; cognitive, functional, and quality‐of‐life measures. RESULTS: Residents with dementia remained in a facility 209 fewer days at the median ( P =.001) than residents without dementia. After adjustment for other variables, lack of treatment for dementia ( P =.01) and more‐serious medical comorbidity ( P =.02) were associated with earlier discharge in participants with dementia. Impaired mobility and limited activity participation had weaker associations with earlier time to discharge. CONCLUSION: Dementia may accelerate time to discharge, and its treatment may attenuate this effect. The hypothesis that the detection and treatment of dementia might delay discharge from AL should be tested in randomized trials.