European Geriatric Medicine

, Volume 9, Issue 4, pp 467–476 | Cite as

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

  • Violetta Kijowska
  • Katarzyna Szczerbińska
Research Paper



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.


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.


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%).


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.


Nursing home Residential home Long-term care Elderly Cognitive impairment Dementia 

List of abbreviations


Activities of daily living


Barthel Index


Cognitive impairment


Cognitive Performance Scale


European Association of Palliative Care


Long-term care


Long-term care institution


Mini-Mental State Examination


Nursing home


Organisation for Economic Co-operation and Development


Residential home



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.


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

Compliance with ethical standards

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.

Supplementary material

41999_2018_62_MOESM1_ESM.pdf (637 kb)
Supplementary material 1 (PDF 637 kb)


  1. 1.
    OECD (2017) Health at a glance 2017: OECD Indicators. OECD Publ 2017.
  2. 2.
    OECD (2013) Health at a glance 2013: OECD Indicators. Paris: 2013.
  3. 3.
    Główny Urząd Statystyczny (2016) Pomoc społeczna i opieka nad dzieckiem i rodziną w 2015 roku (eng. Social assistance, child and family services in 2015). Warszawa: 2016Google Scholar
  4. 4.
    Główny Urząd Statystyczny (2017) Zdrowie i ochrona zdrowia w 2016 roku (eng. Health and health care in 2016). Warszawa: 2017Google Scholar
  5. 5.
    Wagster MV, King JW, Resnick SM, Rapp PR (2012) The 87%: guest editorial. J Gerontol A Biol Sci Med Sci 67:739–740. CrossRefPubMedGoogle Scholar
  6. 6.
    Wang S-Y, Shamliyan TA, Talley KMC, Ramakrishnan R, Kane RL (2013) Not just specific diseases: systematic review of the association of geriatric syndromes with hospitalization or nursing home admission. Arch Gerontol Geriatr 57:16–26. CrossRefPubMedGoogle Scholar
  7. 7.
    Banaszak-Holl J, Fendrick AM, Foster NL, Herzog AR, Kabeto MU, Kent DM et al (2004) Predicting nursing home admission: estimates from a 7-year follow-up of a nationally representative sample of older Americans. Alzheimer Dis Assoc Disord 18:83–89CrossRefPubMedGoogle Scholar
  8. 8.
    Mansbach WE, Mace RA, Clark KM, Firth IM (2017) A comparison of cognitive functioning in long-term care and short-stay nursing home residents. Ageing Soc 37:1–13. CrossRefGoogle Scholar
  9. 9.
    Björk S, Juthberg C, Lindkvist M, Wimo A, Sandman PO, Winblad B et al (2016) Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes. A cross-sectional study. BMC Geriatr 16:154. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Stange I, Poeschl K, Stehle P, Sieber CC, Volkert D (2013) Screening for malnutrition in nursing home residents: comparison of different risk markers and their association to functional impairment. J Nutr Health Aging 17:357–363. CrossRefPubMedGoogle Scholar
  11. 11.
    Selbæk G, Kirkevold Ø, Engedal K (2007) The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes. Int J Geriatr Psychiatry 22:843–849. CrossRefPubMedGoogle Scholar
  12. 12.
    Onder G, Carpenter I, Finne-Soveri H, Gindin J, Frijters D, Henrard JC et al (2012) Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC Health Serv Res 12:5. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Cahill S, Diaz-Ponce AM, Coen RF, Walsh C (2010) The underdetection of cognitive impairment in nursing homes in the Dublin area. The need for on-going cognitive assessment. Age Ageing 39:128–131. CrossRefPubMedGoogle Scholar
  14. 14.
    Kinley J, Hockley J, Stone L, Dewey M, Hansford P, Stewart R et al (2014) The provision of care for residents dying in UK nursing care homes. Age Ageing 43:375–379. CrossRefPubMedGoogle Scholar
  15. 15.
    Hockley J, Watson J, Oxenham D, Murray SA (2010) The integrated implementation of two end-of-life care tools in nursing care homes in the UK: an in-depth evaluation. Palliat Med 24:828–838. CrossRefPubMedGoogle Scholar
  16. 16.
    Helvik A-S, Engedal K, Benth JŠ, Selbæk G (2015) Prevalence and severity of dementia in nursing home residents. Dement Geriatr Cogn Disord 40:166–177. CrossRefPubMedGoogle Scholar
  17. 17.
    OECD/European Commission (2013) A good life in old age? Monitoring and improving quality in long-term care.
  18. 18.
    Bońkowski K, Klich-Rączka A (2007) Ciężka niesprawność czynnościowa osób starszych wyzwaniem dla opieki długoterminowej severe functional impairment in the elderly as a challenge at long-term care. Gerontol Pol 15:97–103Google Scholar
  19. 19.
    Pytka D, Doboszyńska A, Syryło A (2012) Ocena stanu psychofizycznego pacjentów Zakładu Opiekuńczo—Leczniczego “Caritas” Archidiecezji Warszawskiej (eng. Evaluation of psychophysical condition of patients attending the “Caritas” Health Care Centre of the Roman Catholic Archdiocese of Warsaw). Zdr Publ 122:155–159Google Scholar
  20. 20.
    Wdowiak L, Stanisławek D, Stanisławek A (2009) Jakość życia w stacjonarnej opiece długoterminowej. Med Rodz 12:49–63Google Scholar
  21. 21.
    Wróblewska I, Iwaneczko A (2012) Jakość życia pensjonariuszy Domu Pomocy Społecznej ‘Złota Jesień’ w Raciborzu—Badania własne. Fam Med Prim Care Rev 14:573–576Google Scholar
  22. 22.
    Jóźwiak A, Guzik P, Wysocki H (2004) Niski wynik testu Mini Mental State Examination jako czynnik ryzyka zgonu wewnątrzszpitalnego u starszych chorych z niewydolnością serca. Psychogeriatria Pol 1:85–94Google Scholar
  23. 23.
    Górska-Ciebiada M, Saryusz-Wolska M, Ciebiada M, Loba J (2015) Łagodne zaburzenia funkcji poznawczych u chorych na cukrzycę typu 2 w wieku podeszłym (eng. Mild cognitive impairment in elderly patients with type 2 diabetes). Geriatria 9:102–108Google Scholar
  24. 24.
    Pawlak A (2015) Jakość świadczonej opieki w ośrodkach całodobowego pobytu dla osób w wieku podeszłym. Fam Med Prim Care Rev 17:197–201CrossRefGoogle Scholar
  25. 25.
    Kowalska J, Szczepańska-Gieracha J, Piątek J (2010) Zaburzenia poznawcze i emocjonalne a długość pobytu osób starszych w Zakładzie Opiekuńczo-Leczniczym o Profilu Rehabilitacyjnym. Psychogeriatria Pol 7:61–70Google Scholar
  26. 26.
    Kowalska J, Rymaszewska J, Szczepańska-Gieracha J (2013) Occurrence of cognitive impairment and depressive symptoms among the elderly in a nursing home facility. Adv Clin Exp Med 22:111–117PubMedGoogle Scholar
  27. 27.
    Kuźmicz I, Brzostek T, Górkiewicz M (2014) Występowanie odleżyn a sprawność psychoruchowa osób z zaburzeniami funkcji poznawczych, objętych stacjonarną opieką długoterminową. Probl Pielęgniarstwa 22:307–311Google Scholar
  28. 28.
    Reitinger E, Froggatt K, Brazil K, Heimerl K, Hockley J, Kunz R, Parker D, Husebo BS (2013) Palliative care in long-term care settings for older people: findings from an EAPC taskforce. Eur J Palliative Care 20(5):251–253Google Scholar
  29. 29.
    Morris JN, Fries BE, Mehr DR, Hawes C, Phillips C, Mor V et al (1994) MDS Cognitive Performance Scale. J Gerontol 49:M174–M182CrossRefPubMedGoogle Scholar
  30. 30.
    Frederiksen K, Tariot P, De Jonghe E (1996) Minimum data set plus (MDS +) scores compared with scores from five rating scales. J Am Geriatr Soc 44:305–309. CrossRefPubMedGoogle Scholar
  31. 31.
    Snowden M, McCormick W, Russo J, Srebnik D, Comtois K, Bowen J et al (1999) Validity and responsiveness of the minimum data set. J Am Geriatr Soc 47:1000–1004CrossRefPubMedGoogle Scholar
  32. 32.
    Jones K, Perlman CM, Hirdes JP, Scott T (2010) Screening cognitive performance with the resident assessment instrument for mental health Cognitive Performance Scale. Can J Psychiatry 55:736–740. CrossRefPubMedGoogle Scholar
  33. 33.
    Hartmaier SL, Sloane PD, Guess HA, Koch GG, Mitchell CM, Phillips CD (1995) Validation of the minimum data set Cognitive Performance Scale: agreement with the Mini-Mental State Examination. J Gerontol A Biol Sci Med Sci 50:M128–M133CrossRefPubMedGoogle Scholar
  34. 34.
    Paquay L, De Lepeleire J, Schoenmakers B, Ylieff M, Fontaine O, Buntinx F (2007) Comparison of the diagnostic accuracy of the Cognitive Performance Scale (minimum data set) and the mini-mental state exam for the detection of cognitive impairment in nursing home residents. Int J Geriatr Psychiatry 22:286–293. CrossRefPubMedGoogle Scholar
  35. 35.
    Bula CJ, Wietlisbach V (2009) Use of the cognitive performance scale (CPS) to detect cognitive impairment in the acute care setting: concurrent and predictive validity. Brain Res Bull 80:173–178. CrossRefPubMedGoogle Scholar
  36. 36.
    Landi F, Tua E, Onder G, Carrara B, Sgadari A, Rinaldi C et al (2000) Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care 38:1184–1190CrossRefPubMedGoogle Scholar
  37. 37.
    Morris JN, Belleville-Taylor P, Fries BE, Hawes C, Murphy K, Mor V et al (2009) InterRAI long-term care facilities (LTCF) assessment form and user’s manual. Version 9.1. interRAI, Washington, DCGoogle Scholar
  38. 38.
    Jorm AF, Jolley D (1998) The incidence of dementia: a meta-analysis. Neurology 51:728–733CrossRefPubMedGoogle Scholar
  39. 39.
    Unverzagt FW, Gao S, Baiyewu O, Ogunniyi AO, Gureje O, Perkins A et al (2001) Prevalence of cognitive impairment: data from the Indianapolis study of health and aging. Neurology 57:1655–1662CrossRefPubMedGoogle Scholar
  40. 40.
    Rosenthal T (2009) Przewlekłe zaburzenia pamięci. In: Rosenthal TC, Williams MENB (eds) Geriatria. Wyd Czelej, Lublin, pp 291–313Google Scholar
  41. 41.
    McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CRJ, Kawas CH et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:263–269. CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Gutierrez Rodriguez J, Jimenez Muela F, Alonso Collada A, de Santa Maria Benedet LS (2009) Prevalence and therapeutic management of dementia in nursing homes in Asturias (Spain). Rev Esp Geriatr Gerontol 44:31–33. CrossRefPubMedGoogle Scholar
  43. 43.
    Bergh S, Holmen J, Saltvedt I, Tambs K, Selbaek G (2012) Dementia and neuropsychiatric symptoms in nursing-home patients in Nord-Trondelag County. Tidsskr Nor Laegeforen 132:1956–1959. CrossRefPubMedGoogle Scholar
  44. 44.
    Najwyższa Izba Kontroli (2010) Informacja o wynikach kontroli funkcjonowania zakładów opiekuńczoleczniczych (eng. Report on the results of the control of the functioning of long-term care institutions in Poland). Number KPZ-410-09/2009, p 63–66. WarszawaGoogle Scholar

Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  1. 1.Unit for Research on Ageing Society, Department of Sociology of Medicine, Chair of Epidemiology and Preventive Medicine, Medical FacultyJagiellonian University Medical CollegeKrakówPoland

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