Osterweil D, Martin M, Syndulko K
Jewish Home for the Aging, Reseda, CA 91335-3798.
J Am Geriatr Soc. 1995 Feb;43(2):108-12. doi: 10.1111/j.1532-5415.1995.tb06374.x.
To determine if cognitive and functional data gathered before admission to residential care (i.e., board and care) placement can predict nursing home placement.
Retrospective study using Cox proportional hazards analysis and pairwise assessment of adjusted relative risk factors to determine which independent variables predicted skilled nursing placement. Subjects were followed for an average of 23.7 months (SD = 18.6 months).
Multilevel 1,735-bed long-term care facility, Jewish Home for the Aging, Reseda, California.
Of the 248 consecutive residential care admissions studied, 80% were women. Subject's mean age was 84.8 years (SD = 5.0); 67% had no significant cognitive impairment.
Categorical variables were classifications with respect to dementia status, incontinence, hearing, and ambulation. Interval variables were number of medications, Katz ADL, and five neuropsychological tests. Demographic variables were gender, age, language of origin, and education.
Time between preadmission testing and the move up to skilled nursing placement.
Pairwise assessment of adjusted potential risk factors indicated that cognitive dysfunction, less than perfect Katz ADL performance, and hearing loss were the most important independent risk factors for nursing placement.
The findings remind us to pay careful attention to residents exhibiting even relatively mild cognitive deficits upon admission because these residents are likely to need increased environmental support.
确定在入住寄宿护理（即膳宿护理）机构之前收集的认知和功能数据是否能够预测养老院安置情况。
采用Cox比例风险分析和调整后相对风险因素的成对评估进行回顾性研究，以确定哪些自变量能够预测专业护理安置情况。对研究对象平均随访23.7个月（标准差 = 18.6个月）。
加利福尼亚州雷塞达市拥有1735张床位的犹太老年人之家，这是一家多层次的长期护理机构。
在研究的248例连续入住寄宿护理机构的患者中，80%为女性。研究对象的平均年龄为84.8岁（标准差 = 5.0）；67%没有明显的认知障碍。
分类变量包括痴呆状态、大小便失禁、听力和行走能力的分类。间隔变量包括用药数量、Katz日常生活活动能力量表得分以及五项神经心理学测试结果。人口统计学变量包括性别、年龄、母语和教育程度。
入院前测试与转入专业护理安置之间的时间。
对调整后的潜在风险因素进行成对评估表明，认知功能障碍、Katz日常生活活动能力量表得分未达完美水平以及听力损失是护理安置最重要的独立风险因素。
研究结果提醒我们，对于入院时即使表现出相对较轻认知缺陷的居民也要予以密切关注，因为这些居民可能需要更多的环境支持。
