Portia Y Cornell1, Wenhan Zhang1, Lindsey Smith2, Momotazur Rahman1, David C Grabowski3, Paula Carder2, Kali S Thomas4,1. 1. Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA. 2. Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon, USA. 3. Harvard Medical School, Department of Health Care Policy, Boston, Massachusetts, USA. 4. Providence VA Medical Center, Center of Innovation for Long-Term Services and Supports, Providence, Rhode Island, USA.
Abstract
INTRODUCTION: We compare nursing-home and hospital admissions among residents with Alzheimer's disease and related dementias (ADRD) in memory-care assisted living to those in general assisted living. METHODS: Retrospective study of Medicare beneficiaries with ADRD in large (>25 bed) assisted-living communities. We compared admission to a hospital, to a nursing home, and long-term (>90 day) admission to a nursing home between the two groups, using risk differences and survival analysis. RESULTS: Residents in memory-care assisted living had a lower adjusted risk of hospitalization (risk difference = -1.8 percentage points [P = .014], hazard ratio = 0.93 [0.87-1.00]), a lower risk of nursing-home admission (risk difference = -2.2 percentage points [P < .001], hazard ratio = 0.87 [-.79-0.95]), and a lower risk of a long-term nursing home admission (risk difference = -1.1 percentage points [P < .001], hazard ratio = 0.71 [0.57-0.88]). DISCUSSION: Memory care is associated with reduced rates of nursing-home placement, particularly long-term stays, compared to general assisted living.
INTRODUCTION: We compare nursing-home and hospital admissions among residents with Alzheimer's disease and related dementias (ADRD) in memory-care assisted living to those in general assisted living. METHODS: Retrospective study of Medicare beneficiaries with ADRD in large (>25 bed) assisted-living communities. We compared admission to a hospital, to a nursing home, and long-term (>90 day) admission to a nursing home between the two groups, using risk differences and survival analysis. RESULTS: Residents in memory-care assisted living had a lower adjusted risk of hospitalization (risk difference = -1.8 percentage points [P = .014], hazard ratio = 0.93 [0.87-1.00]), a lower risk of nursing-home admission (risk difference = -2.2 percentage points [P < .001], hazard ratio = 0.87 [-.79-0.95]), and a lower risk of a long-term nursing home admission (risk difference = -1.1 percentage points [P < .001], hazard ratio = 0.71 [0.57-0.88]). DISCUSSION: Memory care is associated with reduced rates of nursing-home placement, particularly long-term stays, compared to general assisted living.
Keywords:
Alzheimer's disease and related dementias; assisted living; dementia care; hospitalization; memory care; nursing home admission; residential care
Authors: Cassandra L Hua; Portia Y Cornell; Sheryl Zimmerman; Paula Carder; Kali S Thomas Journal: J Am Med Dir Assoc Date: 2022-08-08 Impact factor: 7.802