The influence of cognitive impairment and behavioral dysregulation on daily functioning in the nursing home setting.
OBJECTIVE
The influence of psychiatric symptoms and cognitive impairment on daily living skills was explored in a series of nursing home residents. Three categories of symptoms were examined: behavioral disturbances, depression, and delusions.


METHODS
Nursing home residents (N=69) underwent comprehensive psychiatric evaluations. Relationships among psychiatric symptoms, cognitive function, and daily living skills were assessed by using regression and correlation analyses.


RESULTS
Cognitive decline had the greatest effect on functional impairment in a standard least squares model, followed by behavioral disturbances. Psychiatric symptoms correlated positively with each other and with functional impairment, and correlated inversely with cognitive functioning.


CONCLUSIONS
Cognitive decline appears to confer the greatest burden of functional disability in the nursing home setting. After cognitive effects were accounted for, behavioral dysregulation was also associated with functional impairment. In conclusion, interventions to enhance cognition and ameliorate behavioral disturbances are important areas for future studies in long-term care.
Schultz
Susan K
SK
Department of Psychiatry, University of Iowa College of Medicine, Iowa City, 52242-1000, USA. Susanschultz@uiowa.edu
Ellingrod
Vicki L
VL
Turvey
Carolyn
C
Moser
David J
DJ
Arndt
Stephan
S
D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D015897:Comorbidity; D003702:Delusions / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D015577:Geriatric Assessment; D006801:Humans; D016018:Least-Squares Analysis; D008134:Long-Term Care / Q000592:standards; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012917:Social Adjustment