Factors associated with care-resistant behavior in the National Alzheimer's Coordinating Center's Uniform Data Set.

INTRODUCTION

Little is known about the factors associated with care-resistant behavior in community-dwelling persons living with dementia.

METHODS

Regression modeling was performed on 41,143 responses to a standardized questionnaire from the National Alzheimer's Coordinating Center's Uniform Data Set.

RESULTS

In the fully adjusted mixed-effects regression model, collinearity was low, with no variance inflation factor above 1.15. Moderate (adjusted odds ratio [aOR] = 1.59; 95% confidence interval [CI]: 1.50, 1.69) and severe (aOR = 1.95; 95% CI: 1.82, 2.09) dementia severity; and Black (aOR = 1.64; 95% CI: 1.47, 1.82), Hispanic ethnicity (aOR 1.13; 95% CI: 1.00, 1.28), frontotemporal (aOR 1.29; 95% CI: 1.12, 1.49) and Lewy body dementia (aOR 1.15; 95% CI: 1.02, 1.29) diagnosis type were associated with a higher odds of care-resistant behavior. Female sex (aOR 0.85; 95% CI: 0.80, 0.91) and higher education (aOR 0.9, 95% CI: 0.84, 0.97) were associated with lower odds of care-resistant behavior.

DISCUSSION

Interventions to manage care-resistant behaviors should consider sociocultural factors as well as type of dementia diagnosis to limit caregiver strain and burden.

HIGHLIGHTS

Frontotemporal dementia, Lewy body dementia, and Black race were associated with a higher likelihood of exhibiting care-resistant behavior. Female sex and higher educational attainment were associated with a lower likelihood of exhibiting care-resistant behavior. Differences in specific presentations of care-resistant behaviors are less understood.