Impact of agitation in long-term care residents with dementia in the United States.

Autor: Fillit H; Geriatric Medicine, Palliative Care and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Aigbogun MS; Health Economics and Outcomes Research, Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ, USA., Gagnon-Sanschagrin P; Analysis Group, Inc., Montreal, QC, Canada., Cloutier M; Analysis Group, Inc., Montreal, QC, Canada., Davidson M; Analysis Group, Inc., Montreal, QC, Canada., Serra E; Analysis Group, Inc., Montreal, QC, Canada., Guérin A; Analysis Group, Inc., Montreal, QC, Canada., Baker RA; Health Economics and Outcomes Research, Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ, USA., Houle CR; Health Economics and Outcomes Research, Lundbeck Pharmaceuticals, Deerfield, IL, USA., Grossberg G; Geriatric Psychiatry, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Jazyk: angličtina
Zdroj: International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2021 Dec; Vol. 36 (12), pp. 1959-1969. Date of Electronic Publication: 2021 Aug 27.
DOI: 10.1002/gps.5604
Abstrakt: Objectives: To describe characteristics and compare clinical outcomes including falls, fractures, infections, and neuropsychiatric symptoms (NPS) among long-term care residents with dementia with and without agitation.
Methods: A cross-sectional secondary analysis of administrative healthcare data was conducted whereby residents with dementia residing in a long-term care facility for ≥12 months were identified from the AnalytiCare LLC database (10/2010-06/2014) and were classified into mutually exclusive cohorts (Agitation Cohort or No-Agitation Cohort) based on available agitation-related symptoms. Entropy balancing was used to balance demographic and clinical characteristics between the two cohorts. The impact of agitation on clinical outcomes was compared between balanced cohorts using weighted logistic regression models.
Results: The study included 6,265 long-term care residents with dementia among whom, 3,313 were included in the Agitation Cohort and 2,952 in the No-Agitation Cohort. Prior to balancing, residents in the Agitation Cohort had greater dementia-related cognitive impairment and clinical manifestations compared to the No-Agitation Cohort. After balancing, residents with and without agitation, respectively, received a median of five and four distinct types of medications (including antipsychotics). Further, compared to residents without agitation, those with agitation were significantly more likely to have a recorded fall (OR = 1.58), fracture (OR = 1.29), infection (OR = 1.18), and other NPS (OR = 2.11).
Conclusions: Agitation in long-term care residents with dementia was associated with numerically higher medication use and an increased likelihood of experiencing falls, fractures, infections, and additional NPS compared to residents without agitation, highlighting the unmet need for effective management of agitation symptoms in this population.
(© 2021 Otsuka Pharmaceutical Development and Commercialization Inc. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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