title: Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents.
abstract: OBJECTIVE
  The purpose of this study was to explore relations among thriving, cognitive function, and neuropsychiatric symptoms (NPS) in nursing home residents.
  
  
  METHODS
  A national, cross-sectional, randomized study of Swedish nursing home residents (N = 4831) was conducted between November 2013 and September 2014. Activities of daily life functioning, cognitive functioning, NPS, and thriving were assessed with the Katz activities of daily living, Gottfries' Cognitive Scale, Nursing Home version of the Neuropsychiatric Inventory, and Thriving of Older People Scale, respectively. Individual NPS were explored in relation to cognitive function. Simple linear and multiple regression models were used to explore thriving in relation to resident characteristics.
  
  
  RESULTS
  Aggression and depressive symptoms were identified as negatively associated with thriving regardless of resident cognitive functioning. At higher levels of cognitive functioning, several factors showed associations with thriving; however, at lower levels of cognitive functioning, only the degree of cognitive impairment and the NPS was associated with thriving. Most of the individual NPS formed nonlinear relationships with cognitive functioning with higher symptom scores in the middle stages of cognitive functioning. Exceptions were elation/euphoria and apathy, which increased linearly with severity of cognitive impairment.
  
  
  CONCLUSIONS
  The lower the cognitive functioning was, the fewer factors were associated with thriving. Aggression and depressive symptoms may indicate lower levels of thriving; thus, targeting these symptoms should be a priority in nursing homes. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Sabine
authors.identifier: http://orcid.org/0000-0002-8107-2860
authors.initials: S
authors.lastname: Björk
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: Lövheim
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.|Department of Statistics, Umeå School of Business and Economics, 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.|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; D000374:Aggression; D060825:Cognitive Dysfunction / Q000523:psychology*; D003430:Cross-Sectional Studies; D005183:Failure to Thrive; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011788:Quality of Life; D012044:Regression Analysis; D012920:Social Behavior Disorders; D013548:Sweden
keywords: cross-sectional study; dementia; frail elderly; neuropsychiatric symptoms; nursing homes; quality of life; thriving