title: Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study.
abstract: Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay.
  
  
  
  Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test.
  
  
  
  The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units.
  
  
  
  The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and initiating future nursing assessments.
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden. sabine.bjork@umu.se.
authors.forename: Sabine
authors.identifier: 0000-0002-8107-2860
authors.initials: S
authors.lastname: Björk
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Juthberg
authors.affiliation: Department of Statistics, Umeå School of Business and Economics, Umeå University, Umeå, Sweden.|Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Lindkvist
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Wimo
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.|Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.|Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Sandman
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Winblad
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.|School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Edvardsson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D015995:Prevalence; D011580:Psychological Techniques; D013223:Statistics as Topic; D013548:Sweden / Q000453:epidemiology
keywords: Activities of daily living; Cross-sectional study; Dementia; Frail elderly; Neuropsychiatric symptoms; Nursing homes; Pain; Prevalence