Alzheimer special care units compared with traditional nursing home for dementia care: are there differences at admission and in clinical outcomes?
Alzheimer Dis Assoc Disord
; 22(4): 352-61, 2008.
Article
en En
| MEDLINE
| ID: mdl-18978601
ABSTRACT
BACKGROUND:
Studies comparing Alzheimer Special Care Units (ASCUs) with traditional nursing homes (NHs) have reported conflicting results.OBJECTIVES:
To compare the characteristics and the effects on mortality, hospitalization, use of physical restraints, falls, and antipsychotics among patients admitted to ASCUs or to NHs.METHODS:
A sequential cohort of patients with dementia was recruited and followed for 18 months in a sample of randomly selected ASCUs and NHs. Data on socio-demographic, cognitive, functional, behavioral, and clinical characteristics, and drug exposure were collected at baseline and at 6-month intervals up to 18 months.RESULTS:
A total of 349 patients were enrolled in 35 ASCUs and 81 in 9 NHs. Patients admitted to ASCUs were younger, cognitively and functionally less impaired, but had more behavioral disturbances than those in NH. During follow-up, ASCU patients had a lower risk of hospitalization (odds ratio 0.67; 95% confidence interval 0.46-0.99; P=0.04), and use of physical restraints (odds ratio 0.66; 95% confidence interval 0.51-0.86; P=0.003), and showed a higher rate of withdrawal of antipsychotics (P=0.003). No difference was found in mortality and falls. Propensity score analysis gives similar results.CONCLUSIONS:
This study found that patients with dementia in ASCUs had different baseline clinical and functional characteristics from those in NHs. They had a lower rate of hospitalization and use of physical restraints at 6-month follow-up, and a higher probability of having antipsychotic agents withdrawn.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Calidad de Vida
/
Demencia
/
Enfermedad de Alzheimer
/
Hogares para Ancianos
/
Casas de Salud
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Alzheimer Dis Assoc Disord
Asunto de la revista:
NEUROLOGIA
/
PSIQUIATRIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Italia