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and use of physical restraints at 6-month follow-up, and a higher probability of having antipsychotic agents withdrawn.
| Original language | English |
|---|---|
| Pages (from-to) | 352-361 |
| Number of pages | 10 |
| Journal | Alzheimer Disease and Associated Disorders |
| Volume | 22 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Oct 2008 |
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Keywords
- Behavioral disturbances
- Dementia
- Nursing home
- Quality of care
- Special care unit
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Psychiatry and Mental health
- Gerontology
- Clinical Psychology
Cite this
Alzheimer special care units compared with traditional nursing home for dementia care : Are there differences at admission and in clinical outcomes? / Nobili, Alessandro; Piana, Ilaria; Balossi, Laura; Pasina, Luca; Matucci, Marina; Tarantola, Massimo; Trevisan, Silvia; Riva, Emma; Lucca, Ugo; Tettamanti, Mauro.
In: Alzheimer Disease and Associated Disorders, Vol. 22, No. 4, 10.2008, p. 352-361.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Alzheimer special care units compared with traditional nursing home for dementia care
T2 - Are there differences at admission and in clinical outcomes?
AU - Nobili, Alessandro
AU - Piana, Ilaria
AU - Balossi, Laura
AU - Pasina, Luca
AU - Matucci, Marina
AU - Tarantola, Massimo
AU - Trevisan, Silvia
AU - Riva, Emma
AU - Lucca, Ugo
AU - Tettamanti, Mauro
PY - 2008/10
Y1 - 2008/10
N2 - 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.
AB - 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.
KW - Behavioral disturbances
KW - Dementia
KW - Nursing home
KW - Quality of care
KW - Special care unit
UR - http://www.scopus.com/inward/record.url?scp=58049190867&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58049190867&partnerID=8YFLogxK
U2 - 10.1097/WAD.0b013e31818207d0
DO - 10.1097/WAD.0b013e31818207d0
M3 - Article
C2 - 18978601
AN - SCOPUS:58049190867
VL - 22
SP - 352
EP - 361
JO - Alzheimer Disease and Associated Disorders
JF - Alzheimer Disease and Associated Disorders
SN - 0893-0341
IS - 4
ER -