Background
Methods
Study design and population
Assessment of cognitive impairment
Assessment of activities of daily living
Item* | Description |
---|---|
Bed mobility | This includes how a resident moves and turns their body position while in bed. |
Transfer | This includes how a resident moves between surfaces such as a bed and chair. |
Locomotion | This includes how a resident moves between locations in their room and corridor outside their room. |
Dressing, | This includes how a resident puts on, fastens, takes off all items of street clothing. |
Eating | This relates to how a resident eats and drinks, including other means of intake of nourishments such as tube feeding. |
Toilet use | This includes how a resident uses a toilet, commode, bedpan or urinal and transfer on and off the toilet. |
Personal hygiene | This relates to how personal hygiene is maintained, including combing hair, brushing teeth, washing and drying face and hands but excluding baths and showers. |
Analytic approach
Ethical review
Results
Sample characteristics and loss to follow-up
Moderate Impairment (CPS 3) N = 7001 | Severe Impairment (CPS 4,5) N = 4616 | |
---|---|---|
Age (%) | ||
< 75 | 906 (8.7) | 383 (8.3) |
75–84 | 2051 (29.3) | 1477 (32.0) |
85–94 | 3501 (50.0) | 2216 (48.0) |
95+ | 840 (12.0) | 540 (11.7) |
Gender (%)
| ||
Male | 1429 (20.4) | 926 (20.1) |
Female | 5572 (79.6) | 3690 (79.9) |
Status at 3 months follow-up (%)
| ||
Still resident in NH | 6518 (93.1) | 4254 (92.2) |
Discharged or transferred | 65 (0.9) | 40 (0.9) |
Deceased | 160 (2.3) | 125 (2.7) |
Lost to follow-up | 258 (3.7) | 201 (4.3) |
Status at 6 month follow-up (%)
| ||
Still resident in NH | 5752 (82.2) | 3642 (78.9) |
3642 (78.9) | 138 (2.0) | 87 (1.9) |
Deceased | 360 (5.1) | 320 (6.9) |
Lost to follow-up | 751 (10.7) | 567 (12.3) |
Mean level of physical function
Change in physical function over time
Change baseline to 3 months (n = 6518) | Change baseline to 6 months (n = 5752) | |||||||
---|---|---|---|---|---|---|---|---|
Mean (SD) | 95% CI | % decline | % improve | Mean (SD) | 95% CI | % decline | % improve | |
ADL Long Form | 1.02 (3.77) | 0.92–1.08 | 45.8 | 27.0 | 1.78 (4.46) | 1.67–1.91 | 55.6 | 24.8 |
Bed mobility | 0.16 (0.93) | 0.14–0.18 | 19.5 | 10.7 | 0.27 (1.06) | 0.25–0.29 | 25.8 | 11.6 |
Transfer | 0.17 (0.90) | 0.15–0.19 | 20.1 | 10.7 | 0.28 (0.99) | 0.27–0.31 | 26.6 | 10.3 |
Locomotion | 0.22 (1.27) | 0.20–0.24 | 20.8 | 11.5 | 0.33 (1.40) | 0.30–0.38 | 27.4 | 12.7 |
Dressing | 0.12 (0.73) | 0.10–0.14 | 19.0 | 10.2 | 0.19 (0.82) | 0.17–0.21 | 25.6 | 11.1 |
Eating | 0.18 (1.00) | 0.15–0.19 | 21.0 | 12.1 | 0.32 (1.13) | 0.31–0.35 | 28.5 | 12.0 |
Toileting | 0.12 (0.80) | 0.10–0.14 | 18.3 | 10.8 | 0.24 (0.91) | 0.21–0.25 | 26.4 | 11.2 |
Personal hygiene | 0.11 (0.70) | 0.09–0.13 | 18.9 | 10.2 | 0.21 (0.80) | 0.19–0.23 | 26.8 | 10.5 |
Change baseline to 3 months (n = 4254) | Change baseline to 6 months (n = 3642) | |||||||
---|---|---|---|---|---|---|---|---|
Mean (SD) | 95% CI | % decline | % improve | Mean (SD) | 95% CI | % decline | % improve | |
ADL Long Form | 0.94 (3.30) | 0.88–1.08 | 48.0 | 25.4 | 1.70 (3.87) | 1.59–1.83 | 57.3 | 22.7 |
Bed mobility | 0.17 (0.91) | 0.14–0.18 | 20.7 | 10.4 | 0.27 (1.03) | 0.23–0.31 | 27.5 | 11.1 |
Transfer | 0.16 (0.87) | 0.14–0.18 | 19.9 | 10.4 | 0.28 (0.97) | 0.24–0.32 | 26.8 | 10.2 |
Locomotion | 0.20 (1.21) | 0.17–0.25 | 20.3 | 11.0 | 0.34 (1.35) | 0.31–0.39 | 28.1 | 11.6 |
Dressing | 0.07 (0.60) | 0.05–0.09 | 15.6 | 9.8 | 0.14 (0.66) | 0.12–0.16 | 21.9 | 10.1 |
Eating | 0.27 (1.04) | 0.25–0.29 | 29.1 | 13.0 | 0.46 (1.15) | 0.41–0.49 | 38.2 | 11.9 |
Toileting | 0.08 (0.67) | 0.07–0.11 | 16.7 | 9.9 | 0.15 (0.72) | 0.13–0.17 | 21.6 | 10.1 |
Personal hygiene | 0.05 (0.54) | 0.04–0.08 | 14.6 | 9.4 | 0.12 (0.63) | 0.10–0.14 | 20.2 | 9.7 |