Association of the Resident Assessment Instrument (RAI) with Changes in Function, Cognition, and Psychosocial Status

Phillips, Charles D.; Morris, John N.; Hawes, Catherine; Fries, Brant E.; Mor, Vincent; Nennstiel, Marianne; Iannacchione, Vincent

doi:10.1111/j.1532-5415.1997.tb02971.x

Cited by 151 publications

(101 citation statements)

References 23 publications

(22 reference statements)

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“…The MDS includes sociodemographic information, clinical items (including physical and cognitive function), clinical diagnoses, and a comprehensive set of symptoms, syndromes, and treatments being provided. 11,12 Summary scales have been derived to determine performance for physical function (activities of daily living [ADLs]) 13 and cognitive ability (cognitive performance scale). 14,15 …”

Section: Methodsmentioning

confidence: 99%

Racial Disparities in Receipt of Secondary Stroke Prevention Agents Among US Nursing Home Residents

Christian

Lapane

Toppa

2003

Stroke

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Background and Purpose-Although medications can significantly reduce the risk of recurrent stroke, little is known about the extent to which such therapies are given to nursing home residents. We sought to evaluate the extent to which people of color were less likely to receive pharmacological agents in the treatment of recurrent stroke while living in US nursing homes. Methods-We identified 19 051 residents with a recent hospitalization and primary discharge diagnosis of 434 or 436 in 5 states from 1992 to 1996; of these, 7053 had concomitant conditions indicating anticoagulant therapy. We considered aspirin, dipyridamole, ticlopidine, or warfarin alone or in combination as secondary drug prevention. Generalized linear models provided estimates of the absolute difference in prevalence estimates of the receipt of agents used for the prevention of recurrent stroke between each race-ethnicity group adjusted for potential confounders. Results-Variability in use of any treatment was observed by race-ethnicity ranging from 58% of American Indians receiving therapy to only 39% of Asian/Pacific Islanders. Among residents with an indication for anticoagulant therapy, the absolute estimated crude differences indicated that residents of color were less likely than non-Hispanic whites to receive warfarin. After controlling for confounding, Asian/Pacific Islanders, blacks, and Hispanics eligible for anticoagulant therapy received warfarin less often than non-Hispanic white residents. Conclusions-Overall, only half of our elderly population received any pharmacological agent for secondary prevention of stroke. Interventions designed to improve the pharmacological management of recurrent stroke regardless of race are needed in the nursing home setting.

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Section: Methodsmentioning

confidence: 99%

Racial Disparities in Receipt of Secondary Stroke Prevention Agents Among US Nursing Home Residents

Christian

Lapane

Toppa

2003

Stroke

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“…Staff evaluated residents in each of these areas using a 5-point scale as independent, needing supervision, needing limited assistance, needing extensive assistance or totally dependent. The validity and reliability of this scale and others as well as their sensitivity to changes over time have previously been documented [24][25][26][27].…”

Section: Mds Assessment Datamentioning

confidence: 99%

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

Landi

Gambassi²,

Lapane³

et al. 1998

Dement Geriatr Cogn Disord

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Cognitive impairment is associated with an increased mortality in older people. The prevalence and impact of comorbidity on functional status and mortality of demented patients has not been fully elucidated. Using a population-based data set, we describe the prevalence of cognitive impairment, functional status, principal comorbid conditions and 1-year survival for over 300,000 patients admitted to the nursing homes in five US states. Sixty-one percent of patients have some level of cognitive impairment, and this correlates with the degree of physical frailty. Severer cognitive impairment is associated with a higher mortality rate. Yet, patients with cognitive impairment appear to have fewer comorbid conditions and are less likely to receive medications and special treatments than residents with normal cognitive status. Additional studies are needed to understand whether demented patients may paradoxically be considered healthier or, instead, are only neglected.

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“…To ascertain physical functioning, we used a 5-item, 6-level activities of daily living (ADL) scale. 40 We defined as decline in physical functioning any increase in the ADL score from the previous assessment, over a 1-year period. As the incident date to calculate the person-years of follow-up, we used the date of death from the Medicare enrollment file for mortality analyses, the date of the earliest inpatient admission from the Medicare inpatient files for each hospitalization outcome, and the date of first decline in ADL performance.…”

Section: Outcome Informationmentioning

confidence: 99%

Effects of Angiotensin-Converting Enzyme Inhibitors and Digoxin on Health Outcomes of Very Old Patients With Heart Failure

Gambassi

Lapane²,

Sgadari³

et al. 2000

Arch Intern Med

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Association of the Resident Assessment Instrument (RAI) with Changes in Function, Cognition, and Psychosocial Status

Cited by 151 publications

References 23 publications

Racial Disparities in Receipt of Secondary Stroke Prevention Agents Among US Nursing Home Residents

Racial Disparities in Receipt of Secondary Stroke Prevention Agents Among US Nursing Home Residents

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

Effects of Angiotensin-Converting Enzyme Inhibitors and Digoxin on Health Outcomes of Very Old Patients With Heart Failure

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