Predictors of care dependency in nursing home residents with moderate to severe dementia: A cross-sectional study.


Journal

International journal of nursing studies
ISSN: 1873-491X
Titre abrégé: Int J Nurs Stud
Pays: England
ID NLM: 0400675

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 27 07 2018
revised: 12 12 2018
accepted: 20 12 2018
pubmed: 1 2 2019
medline: 14 8 2019
entrez: 1 2 2019
Statut: ppublish

Résumé

Nursing home residents with dementia show a rapid decline in their ability to perform activities of daily living. This decline is linked to a greater care dependency, which is associated with a reduced quality of life. Care dependency is influenced by multiple predictors, yet current research often focuses on the contribution of a single or a small number of predictors of care dependency. To examine the contribution of multiple predictors in predicting care dependency. The present study analyzed baseline data from a 6-month double-parallel randomized controlled trial which examined the effect of three physical activity interventions on multiple outcomes. This study was conducted in eleven nursing homes in Bergen op Zoom, the Netherlands. In total, 85 nursing home residents with moderate to severe dementia were included in the study, of which 75 were included for analysis. Predictors considered were cognitive, physical, neuropsychiatric, demographic, and disease related factors. The outcome measure care dependency was assessed with the Care Dependency Scale and the Erlangen Test of Activities of Daily Living. Linear multilevel regression analyses were used to identify the most important predictors of care dependency. Apathy, physical endurance, number of comorbidities, and global cognition were significant predictors of care dependency. The model explained 66% of the variance in care dependency. Global cognition was a significant predictor of ability to perform activities of daily living and explained 60% percent of its variance. The present study shows that multiple predictors (i.e., apathy, cognitive and physical abilities, and disease-related factors) contribute to predicting care dependency. Future research could focus on the effectiveness of multifactorial interventions to maintain the highest possible level of independence in nursing home residents with dementia.

Sections du résumé

BACKGROUND BACKGROUND
Nursing home residents with dementia show a rapid decline in their ability to perform activities of daily living. This decline is linked to a greater care dependency, which is associated with a reduced quality of life. Care dependency is influenced by multiple predictors, yet current research often focuses on the contribution of a single or a small number of predictors of care dependency.
OBJECTIVES OBJECTIVE
To examine the contribution of multiple predictors in predicting care dependency.
DESIGN METHODS
The present study analyzed baseline data from a 6-month double-parallel randomized controlled trial which examined the effect of three physical activity interventions on multiple outcomes.
SETTING METHODS
This study was conducted in eleven nursing homes in Bergen op Zoom, the Netherlands.
PARTICIPANTS METHODS
In total, 85 nursing home residents with moderate to severe dementia were included in the study, of which 75 were included for analysis.
METHODS METHODS
Predictors considered were cognitive, physical, neuropsychiatric, demographic, and disease related factors. The outcome measure care dependency was assessed with the Care Dependency Scale and the Erlangen Test of Activities of Daily Living. Linear multilevel regression analyses were used to identify the most important predictors of care dependency.
RESULTS RESULTS
Apathy, physical endurance, number of comorbidities, and global cognition were significant predictors of care dependency. The model explained 66% of the variance in care dependency. Global cognition was a significant predictor of ability to perform activities of daily living and explained 60% percent of its variance.
CONCLUSION CONCLUSIONS
The present study shows that multiple predictors (i.e., apathy, cognitive and physical abilities, and disease-related factors) contribute to predicting care dependency. Future research could focus on the effectiveness of multifactorial interventions to maintain the highest possible level of independence in nursing home residents with dementia.

Identifiants

pubmed: 30703703
pii: S0020-7489(18)30262-1
doi: 10.1016/j.ijnurstu.2018.12.005
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Pagination

47-54

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Marinda Henskens (M)

Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. Electronic address: m.henskens@vu.nl.

Ilse M Nauta (IM)

Department of Neurology, MS Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.

Katja T Drost (KT)

tanteLouise, Postbus 73, 4600 AB Bergen op Zoom, the Netherlands.

Maarten V Milders (MV)

Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.

Erik J A Scherder (EJA)

Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.

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Classifications MeSH