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Cognitive Change Am...
Cognitive Change Among Nursing Home Residents : CogRisk-NH Scale Development to Predict Decline
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Morris, John N. (author)
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Howard, Elizabeth P. (author)
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Schachter, Erez (author)
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Burney, Sharran (author)
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Laytham, Anna (author)
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Fialova, Daniela (author)
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Hoogendijk, Emiel O. (author)
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Liperoti, Rosa (author)
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van Hout Mpsy, Hein P. J. (author)
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- Vetrano, Davide Liborio (author)
- Karolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),Stockholm Gerontology Research Center, Sweden
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(creator_code:org_t)
- 2023
- 2023
- English.
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In: Journal of the American Medical Directors Association. - 1525-8610 .- 1538-9375. ; 24:9, s. 1405-1411
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objectives: Examine cognitive changes over time among nursing home residents and develop a risk model for identifying predictors of cognitive decline. Design: Using secondary analysis design with Minimum Data Set data, cognitive status was based on the Cognitive Performance Scale (CPS).Setting and Participants: Baseline and 7 quarterly follow-up analyses of US and Canadian interRAI data (N = 1,257,832) were completed. Methods: Logistic regression analyses identified predictors of decline to form the CogRisk-NH scale.Results: At baseline, about 15% of residents were cognitively intact (CPS = 0), and 11.2% borderline intact (CPS = 1). The remaining more intact, with mild impairment (CPS = 2), included 15.0%. Approximately 59% residents fell into CPS categories 3 to 6 (moderate to severe impairment). Over time, increasing proportions of residents declined: 17.1% at 6 months, 21.6% at 9 months, and 34.0% at 21 months. Baseline CPS score was a strong predictor of decline. Categories 0 to 2 had 3-month decline rates in midteens, and categories 3 to 5 had an average decline rate about 9%. Consequently, a 2-submodel construction was employeddone for CPS categories 0 to 2 and the other for categories 3 to 5. Both models were integrated into a 6-category risk scale (CogRisk-NH). CogRisk-NH scale score distribution had 15.9% in category 1, 26.84% in category 2, and 36.7% in category 3. Three higher-risk categories (ie, 4-6) represented 20.6% of residents. Mean decline rates at the 3-month assessment ranged from 4.4% to 28.3%. Over time, differentiation among risk categories continued: 6.9% to 38.4.% at 6 months, 11.0% to 51.0% at 1 year, and 16.2% to 61.4% at 21 months, providing internal validation of the prediction model.Conclusions and Implications: Cognitive decline rates were higher among residents in less-impaired CPS categories. CogRisk-NH scale differentiates those with low likelihood of decline from those with mod-
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- Cognitive Performance Scale
- CPS
- cognitive decline
- older adults
- nursing homes
- long term care facilities
- interRAI
- dementia
- cognitive impairment
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Morris, John N.
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Howard, Elizabet ...
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Schachter, Erez
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Burney, Sharran
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Laytham, Anna
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Fialova, Daniela
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show more...
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Hoogendijk, Emie ...
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Liperoti, Rosa
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van Hout Mpsy, H ...
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Vetrano, Davide ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
- Articles in the publication
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Journal of the A ...
- By the university
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Stockholm University
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Karolinska Institutet