title: Clinical, demographic, and pharmacologic features of nursing home residents with Huntington's disease.
abstract: BACKGROUND
  The purpose of this descriptive, retrospective analysis was to develop a demographic and clinical profile of nursing home residents with a diagnosis of Huntington's disease (HD).
  
  
  METHODS
  Queries were made of a large data repository of linked and de-identified Minimum Data Set version 3.0 and prescription claims records, for the time period of October 1, 2010 through March 31, 2012.
  
  
  RESULTS
  Of 249,811 residents, 340 (0.14%) had a diagnosis of HD; 61% were female and 77.9% were Caucasian. The age range mode was 55-59 years (15%). Approximately one-half of the residents with HD exhibited communication difficulties, 78% had moderate or severe cognitive impairment, and most have significant functional limitations. Depression, dementia, anxiety, psychosis, and bipolar disease were present in 59.4%, 50.9%, 35.9%, and 23.2%, and 9.7%, respectively. Only 21% of residents with HD exhibited troublesome behavioral symptoms. Comorbidities of diabetes and cancer were uncommon (0.3%). Use of physical restraints (excluding bed rails) was considerably higher in residents with HD than in the general nursing home population. Falls were documented in almost one-half of residents. Antipsychotics were used in 61.6% of residents; 16.2% had psychotic symptoms. One was treated with tetrabenazine. Anxiolytics were received by 59.1% of residents, whereas only 35.9% had anxiety noted on Minimum Data Set records.
  
  
  CONCLUSIONS
  The prevalence of HD in US nursing homes is very low (0.14%). Affected residents have significant cognitive and functional impairments, but problematic behaviors are present in only a minority. Serious comorbidities such as cancer and diabetes are rare. Antipsychotics, antidepressants, and anxiolytics are the mainstays of treatment.
authors.affiliation: Omnicare, Inc, Cincinnati, OH. Electronic address: barbara.zarowitz@omnicare.com.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Zarowitz
authors.affiliation: Omnicare, Inc, Cincinnati, OH.
authors.forename: Terrence
authors.initials: T
authors.lastname: O'Shea
authors.affiliation: Struthers Parkinson's Center, Golden Valley, MN; Hennepin County Medical Center, Minneapolis, MN.
authors.forename: Martha
authors.initials: M
authors.lastname: Nance
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002170:Canada / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology; D003680:Deglutition Disorders / Q000453:epidemiology; D006233:Persons with Disabilities; D004363:Drug Utilization / Q000706:statistics & numerical data; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008875:Middle Aged; D051346:Mobility Limitation; D009735:Nursing Homes; D012149:Restraint, Physical / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: Huntington's disease; Nursing home