Corrigendum to: Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors.

To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors. Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities. Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%-11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%-14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%-546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%-11%) reduction in the likelihood of polypharmacy. Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events. Currently, the VPSRACS report on five QI. Previous research has shown associations between several of these indicators, but not all. This paper examines associations between the five VPSRAC QI as well as other key demographic and health-related factors. Novel findings from regression analyses included an increased risk of falls associated with recommended body mass index and using gait aids, but no association between pressure ulcers and the Norton score. Regression models for other QI were limited by the small occurrences of the QI. However, significant associations were identified indicating that residents using a gait aid had a lower level of unplanned weight loss and residents with polypharmacy had higher unplanned weight loss. This paper reinforces the value of collecting VPSRAC QI data to enable facilities to consider how these variables could impact on care quality and to proactively plan to reduce the risk of adverse events. Although QI data can be used to benchmark with other settings, this paper shows how QI data can be used to inform practice within a facility and help identify patient-related factors that may warrant further investigation.

Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors.

OBJECTIVE: To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors. METHODS: Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities. RESULTS: Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%-11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%-14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%-546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%-11%) reduction in the likelihood of polypharmacy. CONCLUSIONS: Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events.

The relationship between apathy and participation in therapeutic activities in nursing home residents with dementia: Evidence for an association and directions for further research.

Apathy is one of the most frequent and early symptoms of dementia. Because apathy is characterised by lack of initiative and motivation, it leads to considerable burden being placed on carers to ensure that the person living with dementia has a reasonable quality of life. The aim of this study was to investigate the relationship between apathy and participation in therapeutic activities for older people with dementia living in nursing homes. Ninety residents were recruited into the study, and apathy was measured by nursing home staff using the Apathy Evaluation Scale Clinician version. Staff also compiled data on each resident's involvement in therapeutic activities. Among this sample, the mean age was 84.8 years, and mean length of stay in the nursing home was 1.8 years. The mean apathy score was 50.4, indicating that on average the residents had a moderate level of apathy. Overall, residents participated in six activities per week and those residents who were involved in the most activities had the lowest levels of apathy. This paper provides evidence that residents involved in therapeutic activities have lower levels of apathy. Further research should be conducted on the direction of causality, whether apathy levels can be changed through participation in therapeutic activities, the relationship between dementia severity and modifiability of apathy, and the intensity of therapeutic activities required to maintain functioning.

Physical activity program preferences and perspectives of older adults with and without cognitive impairment.

INTRODUCTION: There is increasing evidence to support the benefits of physical activity on cognition in older adults. This paper describes (i) the attitudes, beliefs and barriers towards physical activity of older adults with and without cognitive impairment and (ii) their opinion of the attributes of the ideal physical activity program. METHODS: Thematic analysis of focus groups and individual interviews with 50 older adults with no cognitive impairment, subjective memory complaints, mild cognitive impairment and Alzheimer's disease was performed. RESULTS: Consistent with previous research in cognitively intact older adults, most participants, irrespective of cognitive status, had a positive attitude towards physical activity and believed it was beneficial both generally and for cognition. There was a preference for physical activity programs to be suggested by advertising and general practitioners (GPs), undertaken in a group setting, and beliefs that they should be tailored to individual's needs and preferences, and should be affordable according to their income. Participants with cognitive impairment cited specific barriers including "memory" and "lack of companion" as well as preferring "accessible" settings and "simple/light/safe" activities. DISCUSSION: These findings provide useful data, particularly from participants with cognitive impairment, with whom there has been little research to date. This could contribute to efforts to translate the growing research evidence of the benefits of physical activity for brain health into effective community programs.

Media reports on dementia: quality and type of messages in Australian media.

AIM: To analyse changes in the quantity and quality of media reporting about dementia in Australian media between two time periods. METHODS: A media retrieval service collected all news items related to dementia. Quality ratings based on previously developed criteria were made for a stratified random sample of items - 1129 items for 2000/2001 and 1606 for 2006/2007. Nine items of quality were assessed. A summary score for quality was constructed. The content of the sampled media items was also coded. RESULTS: Overall, the mean total quality score for dementia-related items significantly improved over the study period. There were very large improvements in quality of reporting of 'sensationalism', 'language' and 'provision of information about help services' and some small deterioration in quality for 'medical terminology' and 'illness versus person'. CONCLUSIONS: A very positive finding here is that generally the quality of reporting dementia has improved over the period studied.