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Prevalence of cognitive impairment among long-term care residents: a comparison between nursing homes and residential homes in Poland

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Abstract

Purpose

Large-scale nationwide comparative studies of older adults with cognitive impairment (CI) in long-term care institutions (LTCI) hardly exist in Poland. This paper compares the prevalence of CI and its symptoms in residents of nursing homes (NHs) and residential homes (RHs) in Poland.

Methods

A cross-sectional survey of a country-representative sample of 23 LTCIs was conducted in the years 2015–2016. In total, 1587 residents were included: 626 residents in 11 NHs and 961 residents in 12 RHs. All individuals were assessed with a Cognitive Performance Scale (CPS) using a cutoff of ≥ 2 points to define the presence of CI. Descriptive statistics and Chi square test were used.

Results

The median age was 80 years, 67.7% were women. Overall, 65.2% of residents (n = 1035) were identified as having CI, ranging from 59.2% in RHs to 74.5% in NHs, after excluding residents in a coma. Furthermore, the prevalence of severe CI was significantly higher in NHs than in RHs (respectively, 41.2 and 20.5%). It concerned specifically impairment of memory: procedural (72.3 vs 55.2%), long-term (56.5 vs 32.1%), short-term (46.8 vs 33.4%), and situational one (40.2 vs 26.4%), as well as problems with being understood by others (44.6 vs 24.7%) and severely impaired capacity of daily decision making (44.7 vs 21.5%).

Conclusions

A high prevalence of CI was found in both LTCI types, but its severity differed, with statistically significantly higher rates in NHs compared to RHs. Therefore, we call for more attention to be paid to better recognition of CI in LTCI residents, regardless of the facility type.

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Abbreviations

ADL:

Activities of daily living

BI:

Barthel Index

CI:

Cognitive impairment

CPS:

Cognitive Performance Scale

EAPC:

European Association of Palliative Care

LTC:

Long-term care

LTCI:

Long-term care institution

MMSE:

Mini-Mental State Examination

NH:

Nursing home

OECD:

Organisation for Economic Co-operation and Development

RH:

Residential home

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Acknowledgments

The authors would like to thank the managers of long-term care institutions in Poland who allowed the study to be conducted in their settings and to the facilities’ nursing staff for participating in collecting the data.

Funding

This work was supported by the Jagiellonian University Medical College (Grant No. K/DSC/003080). Grant recipient: Violetta Kijowska, MPH.

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Authors and Affiliations

  1. Unit for Research on Ageing Society, Department of Sociology of Medicine, Chair of Epidemiology and Preventive Medicine, Medical Faculty, Jagiellonian University Medical College, Kopernika 7a Street, 31-034, Kraków, Poland

    Violetta Kijowska & Katarzyna Szczerbińska

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  1. Violetta Kijowska
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  2. Katarzyna Szczerbińska
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Corresponding author

Correspondence to Katarzyna Szczerbińska.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

The authors declare that the study has been registered and accepted by the Jagiellonian University Ethics Committee (Agreement No. 122.6120.31.2015) and it was conducted in line of the current laws, meeting the standard requirements.

Informed consent

Based on the Jagiellonian University Ethics Committee approval, informed consent was obtained from all settings where the study was conducted. Data collected in the study were analyzed anonymously by researchers without any possibility of identification of individual residents.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Kijowska, V., Szczerbińska, K. Prevalence of cognitive impairment among long-term care residents: a comparison between nursing homes and residential homes in Poland. Eur Geriatr Med 9, 467–476 (2018). https://doi.org/10.1007/s41999-018-0062-2

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