Predicting functional decline of older men living in veteran homes by minimum data set: implications for disability prevention programs in long term care settings.

ABSTRACT

OBJECTIVE: To evaluate the risk and protective factors for functional decline of veteran home residents in Taiwan to develop disability prevention programs in long term care settings. DESIGN: A prospective cohort study. SETTING: Two veteran homes in Taiwan. PARTICIPANTS: A total of 1045 residents of veteran homes. INTERVENTION None. MEASUREMENTS Minimum data set (MDS), resident assessment protocols (RAP), MDS-COGS, Resource Utilization Group-III Activities of Daily Living scale, MDS Social engagement scale, MDS Pain scale. RESULTS: A total of 1045 (83.0 ± 5.1 years, all men) residents completed the study, and 11.3% of them developed significant functional decline during the study period. Participants with long-term institutionalization history (odds ratio [OR] 2.966, confidence interval [CI] 1.270-6.927), underlying cerebrovascular disease (OR 4.432, CI 1.994-9.852) and dementia (OR 2.150, CI 1.029-4.504), and higher sum of RAP triggers (OR 1.366, CI 1.230-1.517) were more likely to develop functional decline, whereas those who had better social engagement were significantly protective from functional decline (OR 0.528, CI 0.399-0.697). CONCLUSIONS: Cerebrovascular disease, dementia, higher sum of RAP triggers, and long-term institutionalization were independent risk factors for functional decline, whereas better social engagement had a protective effect on functional dependence. Further study is needed to develop an integrated disability prevention program based on the discoveries of this study.