title: Physical Restraint and Antipsychotic Medication Use Among Nursing Home Residents With Dementia.
abstract: OBJECTIVE
  To explore antipsychotic (AP) medications and physical restraint use and their effects on physical function and cognition in older nursing home residents.
  
  
  METHODS
  This retrospective cohort studied involved 532 residents with dementia from 57 nursing homes participating in the Services and Health for Elderly in Long-Term Care study. Poisson log regression models explored the effect of physical restraint and/or AP medication use on cognitive or functional decline at 6 months.
  
  
  RESULTS
  Physical restraint use was associated with a higher risk of both functional and cognitive decline compared with AP medication use alone. These risks were highest among residents receiving both AP medications and physical restraints, suggesting additive effects.
  
  
  CONCLUSIONS
  Physical restraint use, and even more strongly, concurrent physical restraint and AP medication use, is related to function and cognitive decline in nursing home residents with dementia. Antipsychotic use is cautioned, but these results suggest physical restraint use is potentially more risky.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: andrea.foebel@ki.se.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Foebel
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: Aging and Services Unit, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.affiliation: AGAPLESION Bethesda Clinic, Geriatric Center, Ulm University, Ulm, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Lukas
authors.affiliation: AGAPLESION Bethesda Clinic, Geriatric Center, Ulm University, Ulm, Germany.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Denkinger
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Carfi
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Davide L
authors.initials: DL
authors.lastname: Vetrano
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Brandi
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Liperoti
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003704:Dementia; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D014150:Antipsychotic Agents
keywords: Physical restraint; activities of daily living; antipsychotics; cognition; dementia; nursing homes