Skilled Nursing Facility Utilization Among Community-Dwelling Older Adults With Alzheimer's Disease and Related Dementias During the COVID-19 Pandemic.

IF 4.2 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Meiling Ying, Zijing Cheng, Richard A Hirth, Brent K Hollenbeck, Karen E Joynt Maddox, Vahakn B Shahinian, Yue Li
{"title":"Skilled Nursing Facility Utilization Among Community-Dwelling Older Adults With Alzheimer's Disease and Related Dementias During the COVID-19 Pandemic.","authors":"Meiling Ying, Zijing Cheng, Richard A Hirth, Brent K Hollenbeck, Karen E Joynt Maddox, Vahakn B Shahinian, Yue Li","doi":"10.1016/j.jamda.2025.105551","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between skilled nursing facility (SNF) utilization and Alzheimer's disease and related dementias (ADRD) both before and during the COVID-19 pandemic.</p><p><strong>Design: </strong>An observational cohort study.</p><p><strong>Setting and participants: </strong>The study included community-dwelling respondents aged 65 or older.</p><p><strong>Methods: </strong>This study analyzed data from 3 waves of the Health and Retirement Study and employed multivariable, individual-level regressions. The primary outcomes were any SNF stays, the number of SNF stays, and the total number of SNF days, in the past 2 years of the survey. Respondents were classified as cognitively normal, having cognitive impairment but not dementia (CIND), or having ADRD.</p><p><strong>Results: </strong>The study included 23,654 respondent-years, representing 12,529 unique respondents. Before the pandemic, differences in any SNF stays, and the number of SNF stays between the cognitively normal and CIND and ADRD groups were statistically insignificant in multivariable regressions. During the pandemic, compared with respondents with normal cognition, those with CIND had higher odds of any SNF stays (OR, 1.53; 95% CI, 1.06-2.20) and more SNF stays (incidence rate ratio [IRR], 2.40; 95% CI, 1.30-4.40); similarly, the ADRD group showed higher odds of any SNF stays (OR, 1.68; 95% CI, 1.08-2.59) and more SNF stays (IRR, 2.48; 95% CI, 1.36-4.47) than cognitively normal older adults. The total number of SNF days for CIND and ADRD respondents remained statistically insignificantly different from those of the cognitively normal group, both before and during the pandemic, in regression analyses.</p><p><strong>Conclusions and implications: </strong>This cohort study suggests that the pandemic was associated with increased differences in any SNF stays and number of transitions to SNFs between cognitively normal individuals and those with CIND or ADRD. These findings provide a foundation for understanding the potential impact of a public health emergency on post-acute care utilization among older adults with varying degrees of cognitive impairment.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105551"},"PeriodicalIF":4.2000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Medical Directors Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jamda.2025.105551","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To assess the association between skilled nursing facility (SNF) utilization and Alzheimer's disease and related dementias (ADRD) both before and during the COVID-19 pandemic.

Design: An observational cohort study.

Setting and participants: The study included community-dwelling respondents aged 65 or older.

Methods: This study analyzed data from 3 waves of the Health and Retirement Study and employed multivariable, individual-level regressions. The primary outcomes were any SNF stays, the number of SNF stays, and the total number of SNF days, in the past 2 years of the survey. Respondents were classified as cognitively normal, having cognitive impairment but not dementia (CIND), or having ADRD.

Results: The study included 23,654 respondent-years, representing 12,529 unique respondents. Before the pandemic, differences in any SNF stays, and the number of SNF stays between the cognitively normal and CIND and ADRD groups were statistically insignificant in multivariable regressions. During the pandemic, compared with respondents with normal cognition, those with CIND had higher odds of any SNF stays (OR, 1.53; 95% CI, 1.06-2.20) and more SNF stays (incidence rate ratio [IRR], 2.40; 95% CI, 1.30-4.40); similarly, the ADRD group showed higher odds of any SNF stays (OR, 1.68; 95% CI, 1.08-2.59) and more SNF stays (IRR, 2.48; 95% CI, 1.36-4.47) than cognitively normal older adults. The total number of SNF days for CIND and ADRD respondents remained statistically insignificantly different from those of the cognitively normal group, both before and during the pandemic, in regression analyses.

Conclusions and implications: This cohort study suggests that the pandemic was associated with increased differences in any SNF stays and number of transitions to SNFs between cognitively normal individuals and those with CIND or ADRD. These findings provide a foundation for understanding the potential impact of a public health emergency on post-acute care utilization among older adults with varying degrees of cognitive impairment.

COVID-19大流行期间社区居住老年阿尔茨海默病和相关痴呆患者熟练护理机构的使用情况
目的:评估2019冠状病毒病(COVID-19)大流行前后熟练护理设施(SNF)利用与阿尔茨海默病及相关痴呆(ADRD)的关系。设计:观察性队列研究。环境和参与者:该研究包括65岁或以上的社区居民。方法:本研究分析了健康与退休研究的三波数据,并采用多变量、个体水平回归。主要结果是在过去2年的调查中,任何SNF停留、SNF停留次数和SNF总天数。受访者被归类为认知正常,有认知障碍但没有痴呆症(CIND),或患有多动症。结果:该研究包括23,654个受访者年,代表12,529个独特的受访者。在大流行之前,认知正常组与CIND和ADRD组之间任何SNF停留时间的差异以及SNF停留时间的数量在多变量回归中统计学上不显著。在大流行期间,与认知正常的应答者相比,CIND患者出现SNF停留的几率更高(OR, 1.53;95% CI, 1.06-2.20)和更多SNF停留(发病率比[IRR], 2.40;95% ci, 1.30-4.40);同样,ADRD组SNF持续的几率更高(OR, 1.68;95% CI, 1.08-2.59), SNF停留时间更长(IRR, 2.48;95% CI, 1.36-4.47),高于认知正常的老年人。在回归分析中,在大流行之前和期间,CIND和ADRD应答者的SNF总天数与认知正常组的SNF总天数在统计学上没有显著差异。结论和意义:该队列研究表明,大流行与认知正常个体与CIND或ADRD患者之间SNF停留时间和向SNF过渡次数的差异增加有关。这些发现为了解突发公共卫生事件对不同程度认知障碍老年人急性后护理利用的潜在影响提供了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信