Does cognitive impairment influence quality of life among nursing home residents?
OBJECTIVE
We investigated the relationship between cognitive status and quality of life (QOL) of Minnesota nursing home (NH) residents and the relationship between conventional or Alzheimer's special care unit (SCU) placement and QOL. The study may inform development of dementia-specific quality measures.


METHODS
Data for analyses came from face-to-face interviews with a representative sample of 13,130 Minnesota NH residents collected through the 2007 Minnesota NH Resident Quality of Life and Consumer Satisfaction survey. We examined 7 QOL domains: comfort, meaningful activities, privacy, environment, individuality, autonomy, relationships, and a positive mood scale. We applied multilevel models (resident and facility) to examine the relationship between the resident's score on each QOL domain and the resident's cognitive impairment (CI) level and SCU placement after controlling for covariates, such as activities of daily living dependency, pain, depression or psychiatric diagnosis, and length of stay.


RESULTS
Residents with more severe CI reported higher QOL in the domains of comfort and environment and lower QOL in activities, individuality, privacy and meaningful relationships, and the mood scale. Residents on SCU reported higher QOL in the meaningful activities, comfort, environment, and autonomy domains but had lower mood scores.


CONCLUSIONS
Our findings point to QOL domains that show significant variation by CI and thus may be of greatest interest to consumers, providers, advocacy groups, and other stakeholders committed to improving dementia care. Findings are particularly applicable to the development of NH quality indicators that more accurately represent the QOL of NH residents with CI.
Department of Public Health, Western Kentucky University, 1906 College Heights Boulevard, Bowling Green, KY 42101, USA. kathleen.abrahamson@wku.edu
Kathleen
K
Abrahamson
Daniel
D
Clark
Anthony
A
Perkins
Greg
G
Arling
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000523:psychology*; D003258:Consumer Behavior; D005260:Female; D019538:Health Care Surveys; D006707:Homes for the Aged; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008910:Minnesota; D009735:Nursing Homes; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D012931:Social Environment