Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study

Abstract

BackgroundEarlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay.MethodsCross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test.ResultsThe results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units.ConclusionsThe prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and initiating future nursing assessments.

Residents’ engagement in everyday activities and its association with thriving in nursing homes

“…The remaining (42%) of the assessments were completed by a staff member knowing the resident ‘well’ by interacting with the resident weekly (Björk et al . ).…”

A Dedicated Nutritional Care Program (NUTRICARE) to reduce malnutrition in institutionalised dysphagic older people: A quasi‐experimental study

“…Malnutrition remains a clinical priority in 20%–66.5% institutionalised older people (Namasivayam & Steele, ; Papparotto, Bidoli, & Palese, ). In nursing homes, older dysphagic patients often suffer from cognitive impairment (Björk et al., ) and are also more at risk of malnutrition and sarcopaenia. The risk of malnutrition increases in relation to the presence of cognitive impairment (OR: 1.844; p = .001), dementia (OR: 2.139; p = .001), but also in relation to the mere condition of dependency during meals (OR: 2.257; p = .001; Moreira et al., ).…”

The thriving of older people assessment scale: Psychometric evaluation and short‐form development

“…Given that a large proportion of nursing home residents, and almost two‐thirds of the sample in this study, are recognized as potentially having some form of cognitive impairment, it seemed important to first examine the feasibility of the TOPAS for proxy‐rated use in this population (Björk et al, ; Björk, Lövheim, et al, ). Previous testing of the 32‐item TOPAS suggested that the scale produced reliable proxy ratings when comparing mentally lucid residents’ self‐ratings, staff proxy ratings and relative proxy ratings (Bergland et al, ).…”

“…Nursing home staff provided demographic information for residents and answered survey questions as proxy raters regarding cognitive status, activity function and thriving (Edvardsson et al, ). Proxy ratings were used based on the suspected, and later confirmed, high prevalence of cognitive impairment among Swedish nursing home residents (Björk et al, ). No identifying information was collected for residents or staff.…”