Increase Use of Nursing Home for Patients With Cognitive Impairment Category

HealthDay News — Nursing home (NH) use increases with increasing cognitive impairment category, according to a study published online in the Journal of the American Geriatrics Society.

Jane A. Emerson, from the Mayo Clinic in Rochester, Minnesota, and colleagues estimated NH use among 3545 Mayo Clinic Study of Aging participants (aged 70 to 89 years), assessed as cognitively normal (CN), mild cognitive impairment (MCI), previously unrecognized dementia, or prevalent dementia.

The researchers found that the percentages who died in the year after cognition was assessed were 1%, 2.6%, 4.2%, and 21%among those categorized as CN, MCI, previously unrecognized dementia, and prevalent dementia, respectively. The percentages with any NH use were 3.8%, 8.7%, 19%, and 40%, respectively, with 27, 38, 120, and 305 median NH days and 7.8%, 12%, 33%, and 100% median percentages of NH days/days of observation, respectively.

A significantly higher proportion had any NH use for each increase in cognitive impairment category. Individuals with prevalent dementia and any NH use had especially high one-year mortality (30% vs 13% for those with no NH use). Among those with prevalent dementia, 58% of all deaths occurred while an NH resident.

“Reductions in NH use could result from quality alternatives to NH admission, both among persons with MCI and persons with dementia, together with suitable options for end-of-life care among persons with prevalent dementia,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including AbbVie, which partially funded the study.

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Emerson JA, Smith CY, Long KH, et al. Nursing home use across the spectrum of cognitive decline: merging mayo clinic study of aging with CMS MDS assessments. J Am Geriatr Soc. 2017;65(10):2235-2243.