title: Effect of dementia and treatment of dementia on time to discharge from assisted living facilities: the Maryland assisted living study.
abstract: OBJECTIVE
  To estimate the association between dementia and time to discharge from individual assisted living (AL) facilities and examine, in residents with dementia, factors associated with shorter duration of residence in individual AL facilities.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Twenty-two AL facilities in central Maryland.
  
  
  METHODS
  Stratified random sample of 198 AL residents followed for a median of 18 months.
  
  
  METHODS
  Detailed assessments to diagnose dementia; assess treatment of dementia; and rate clinical; cognitive, functional, and quality-of-life measures.
  
  
  RESULTS
  Residents with dementia remained in a facility 209 fewer days at the median (P=.001) than residents without dementia. After adjustment for other variables, lack of treatment for dementia (P=.01) and more-serious medical comorbidity (P=.02) were associated with earlier discharge in participants with dementia. Impaired mobility and limited activity participation had weaker associations with earlier time to discharge.
  
  
  CONCLUSIONS
  Dementia may accelerate time to discharge, and its treatment may attenuate this effect. The hypothesis that the detection and treatment of dementia might delay discharge from AL should be tested in randomized trials.
authors.affiliation: Department of Psychiatry Johns Hopkins Bayview, Johns Hopkins Medicine, Maryland 21224, USA. kostas@jhmi.edu
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.forename: Quincy M
authors.initials: QM
authors.lastname: Samus
authors.forename: Alva
authors.initials: A
authors.lastname: Baker
authors.forename: Mathew
authors.initials: M
authors.lastname: McNabney
authors.forename: Chiadi U
authors.initials: CU
authors.lastname: Onyike
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Mayer
authors.forename: Jason
authors.initials: J
authors.lastname: Brandt
authors.forename: Peter
authors.initials: P
authors.lastname: Rabins
authors.forename: Adam
authors.initials: A
authors.lastname: Rosenblatt
mesh_terms: D000369:Aged, 80 and over; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003704:Dementia / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008396:Maryland / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012307:Risk Factors
chemical_list: D011619:Psychotropic Drugs