Samus Quincy M, Mayer Lawrence, Onyike Chiadi U, Brandt Jason, Baker Alva, McNabney Matthew, Rabins Peter V, Lyketsos Constantine G, Rosenblatt Adam
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 North Broadway, Baltimore, MD 21205, USA.
J Am Med Dir Assoc. 2009 Jun;10(5):323-9. doi: 10.1016/j.jamda.2009.01.004.
To describe and contrast functional dependency (FD) levels among recently admitted AL residents with and without dementia and to assess the differential contribution of cognitive, behavioral, medical, and social factors on FD within each group.
A cross-sectional study.
A random sample of 28 AL facilities in the Central Maryland region.
Two hundred and sixty-two AL residents assessed less than 1 year after admission.
Participants were given comprehensive in-person dementia assessments. Cognitive, behavioral, medical, and social factors were also assessed. FD was operationalized as impairment in activities of daily living.
The 59% of residents with dementia had higher levels of FD (P < .001) and were more likely to require assistance in all assessed task-specific ADL domains (P < .001) except mobility (P = .653). In multivariate models, global cognition, medical health status, and presence of diabetes explained 43% of the variance in FD in the dementia group. Twenty-five percent of the variance in FD was explained by depression, neuropsychiatric symptoms, and global cognition in those without dementia.
Recently admitted AL residents have substantial levels of FD. FD is higher among residents with dementia compared with those without and the association of cognitive, mental health, and medical variables with FD differ as a function of dementia status. Future research should examine how these dimensions affect FD longitudinally and whether they may serve as targets for interventions and quality of care improvement initiatives.
描述并对比近期入住养老院且患有和未患有痴呆症的居民的功能依赖（FD）水平，并评估认知、行为、医疗和社会因素在每组中对FD的不同贡献。
横断面研究。
马里兰州中部地区28家养老院的随机样本。
262名入住养老院不到1年的居民。
对参与者进行全面的面对面痴呆症评估。还评估了认知、行为、医疗和社会因素。FD被定义为日常生活活动受损。
59%的痴呆症患者FD水平较高（P < .001），并且在所有评估的特定任务日常生活活动领域中更有可能需要帮助（P < .001），但行动能力方面除外（P = .653）。在多变量模型中，整体认知、医疗健康状况和糖尿病的存在解释了痴呆症组中FD变异的43%。在没有痴呆症的人群中，FD变异的25%由抑郁、神经精神症状和整体认知解释。
近期入住养老院的居民有相当程度的功能依赖。与未患痴呆症的居民相比，患痴呆症居民的功能依赖程度更高，并且认知、心理健康和医疗变量与功能依赖的关联因痴呆症状态而异。未来的研究应探讨这些维度如何随时间纵向影响功能依赖，以及它们是否可作为干预措施和改善护理质量举措的目标。
