Clinical characteristics and six-month outcomes of nursing home residents with low activities of daily living dependency

Background. Up to 30% of nursing home residents have very little dependency in activities of daily living (ADLs). We compared the characteristics and six-month outcomes of a sample of low-ADL-dependent nursing home residents (LDR) with other residents. Methods. This is a cross-sectional, six-month follow-up study using seconda ry data analysis. We combined the separate 1990 and 1993 cohorts in the Res ident Assessment Instrument evaluation study. In each case these data were collected in the same 254 nursing homes in 10 states. We studied residents with a length of stay greater than 60 days and age 65 years and older (N = 3955). We compared the baseline characteristics of LDR (n = 985) with all o ther residents. We then compared six-month outcomes of LDR with other resid ents and characteristics of LDR with poor outcomes (death or worsened ADL d isability) with LDR who remained stable. Results. The LDR had a significantly decreased frequency of geriatric syndr omes (i.e., cognitive impairment, urinary incontinence, under-nutrition, vi sion problems, poor balance, and pressure ulcers) and neurological disease but had the same frequency of non-neurological chronic diseases and were on more medications. Thirty-one percent had poor six-month outcomes associate d with baseline poor cognition, incontinence, poor appetite, and presence o f vascular disease, daily pain, shortness of breath, and multiple medicatio ns. Conclusion. Our research identified 29% of nursing home residents with high er physical function (LDR) who had fewer geriatric syndromes and neurologic al disease diagnoses; 69% of these remained stable at 6 months. Those LDR w ith a higher risk of poor outcomes could be prospectively identified. LDR w ho remained stable for 6 months may represent a group who could potentially be maintained in the community.