4.5 Article

Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents

Journal

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY
Volume 33, Issue 1, Pages E49-E57

Publisher

WILEY
DOI: 10.1002/gps.4714

Keywords

neuropsychiatric symptoms; dementia; nursing homes; frail elderly; thriving; quality of life; cross-sectional study

Funding

  1. Swedish Research Council for Health, Working Life, and Welfare: Forte [2014-4016]
  2. Swedish Research Council [521-2014-2715]
  3. Swedish Foundation for Health Care Sciences and Allegy Research
  4. University of Gothenburg Centre for Person-centred Care

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ObjectivesThe purpose of this study was to explore relations among thriving, cognitive function, and neuropsychiatric symptoms (NPS) in nursing home residents. MethodsA national, cross-sectional, randomized study of Swedish nursing home residents (N=4831) was conducted between November 2013 and September 2014. Activities of daily life functioning, cognitive functioning, NPS, and thriving were assessed with the Katz activities of daily living, Gottfries' Cognitive Scale, Nursing Home version of the Neuropsychiatric Inventory, and Thriving of Older People Scale, respectively. Individual NPS were explored in relation to cognitive function. Simple linear and multiple regression models were used to explore thriving in relation to resident characteristics. ResultsAggression and depressive symptoms were identified as negatively associated with thriving regardless of resident cognitive functioning. At higher levels of cognitive functioning, several factors showed associations with thriving; however, at lower levels of cognitive functioning, only the degree of cognitive impairment and the NPS was associated with thriving. Most of the individual NPS formed nonlinear relationships with cognitive functioning with higher symptom scores in the middle stages of cognitive functioning. Exceptions were elation/euphoria and apathy, which increased linearly with severity of cognitive impairment. ConclusionsThe lower the cognitive functioning was, the fewer factors were associated with thriving. Aggression and depressive symptoms may indicate lower levels of thriving; thus, targeting these symptoms should be a priority in nursing homes. Copyright (c) 2017 John Wiley & Sons, Ltd.

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