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Journal of Clinical Geropsychology

, Volume 8, Issue 4, pp 335–342 | Cite as

Anxiety Symptoms as Predictors of Nursing Home Placement in Patients with Alzheimer's Disease

  • Laura E. Gibbons
  • Linda Teri
  • Rebecca Logsdon
  • Susan M. McCurry
  • Walter Kukull
  • James Bowen
  • Wayne McCormick
  • Eric Larson
Article

Abstract

Anxiety symptoms are fairly common among patients with Alzheimer's Disease (AD). Such symptoms are likely to make patient care more problematic and, therefore, increase the risk of nursing home placement. Anxiety symptoms were evaluated on the basis of physician examinations, in conjunction with caregiver interviews, in 372 community-dwelling AD patients. Patients received annual follow-up for 1–12 years (M = 4.4). Patients who exhibited anxiety symptoms at baseline assessment were significantly more likely to enter nursing homes, regardless of initial cognitive status or other risks for institutionalization. There was a 15% increase in risk for each point on a 0–5 scale. This study supports the hypothesis that anxiety symptoms increase the risk of nursing home placement in patients with AD. Consequently, there is a need for better understanding of the causes of anxiety in AD and for the development of effective methods of assessment and treatment.

Alzheimer's disease anxiety behavioral symptoms institutionalization prospective studies 

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REFERENCES

  1. Bianchetti, A., Scuratti, A., Zanetti, O., Binetti, G., Frisoni, G. B., Magni, E., and Trabucchi, M. (1995). Predictors of mortality and institutionalization in Alzheimer's disease patients 1 year after discharge from an Alzheimer dementia unit. Dementia 6: 108–112.Google Scholar
  2. Chang, B. L. (1999). Cognitive-behavioral intervention for homebound caregivers of persons with dementia. Nurs. Res. 48: 173–182.Google Scholar
  3. Cohen, C. A., Gold, D. P., Shulman, K. I., Whortley, J. T., McDonald, G., and Wargon, M. (1993). Factors determining the decision to institutionalize dementing individuals: A prospective study. Gerontologist 33: 714–720.Google Scholar
  4. Corey-Bloom, J., and Gasasko, D. (1995). Adjunctive therapy in patients with Alzheimer's disease. Drugs Aging 7: 79–87. 342 Gibbons, Teri, Logsdon, McCurry, Kukull, Bowen, McCormick, and Larson Google Scholar
  5. Hope, T., Keene, J., Gedling, K., Fairburn, C. G., and Jacoby, R. (1998). Predictors of institutionalization for people with dementia living at home with a carer. Int. J. Geriat. Psychiatry 13: 682–690.Google Scholar
  6. Karlsson, I. (1996). Treatment of non-cognitive symptoms in dementia. Acta Neurol. Scand. 168(Suppl.): 93–95.Google Scholar
  7. Larson, E. B., Kukull, W. A., Teri, L., McCormick, W., Pfanschmidt, M., van Belle, G., and Sumi, M. (1990). University of Washington Alzheimer's Disease Patient Registry (ADPR): 1987-1988. Aging 2: 404–408.Google Scholar
  8. McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 34: 939–944.Google Scholar
  9. Mega, M., Cummings, J., Fiorello, T., and Gornbein, J. (1996). The spectrum of behavioral changes in Alzheimer's disease. Neurology 46: 130–135.Google Scholar
  10. Mehrabian, A. (1995). Distinguishing depression and trait anxiety in terms of basic dimensions of temperament. Imaginat. Cognit. Pers. 15: 133–143.Google Scholar
  11. Mittelman, M. S., Ferris, S. H., Shulman, E., Steinberg, G., and Levin, B. (1996). A family intervention to delay nursing home placement of patients with Alzheimer's disease: A randomized, controlled trial. JAMA 276: 1725–1731.Google Scholar
  12. O'Donnell, B. F., Drachman, D. A., Barnes, H. J., Peterson, K. E., Swearer, J. M., and Lew, R. A. (1992). Incontinence and troublesome behaviors predict institutionalization in dementia J. Geriatr. Psychiatry Neurol. 5: 45–52.Google Scholar
  13. Reisberg, B., Borenstein, J., Salob, S. P., Ferris, S. H., Franssen, E., and Georgotas, A. (1987). Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. J. Clin. Psychiatry 48(Suppl. 5): 9–15.Google Scholar
  14. Rockwood, K., Stolee, P., and Brahim, A. (1991). Outcomes of admission to a psychogeriatric service. Can. J. Psychiatry 36: 275–279.Google Scholar
  15. Shankarr, K. K., Walker, M., Frost, D., and Orrell, M. W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging Mental Health 1: 39–49.Google Scholar
  16. Steele, C., Rovner, B., Chase, G., and Folstein, M. (1990). Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. Am. J. Psychiatry 147: 1049–1051.Google Scholar
  17. Teri, L., Ferretti, L. E., Gibbons, L. E., Logsdon, R. G., McCurry, S. M., Kukull, W. A., McCormick, W. C., Bowen, J. D., and Larson, E. B. (1999). Anxiety in Alzheimer's disease: Prevalence and comorbidity. J. Gerontol. 54: 348–352.Google Scholar
  18. Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S., and Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: The Revised Memory and Behavior Problems Checklist. Psychol. Aging 7: 622–631.Google Scholar
  19. Vernooij-Dassen, M., Felling, A., and Persoon, J. (1997). Predictors of change and continuity in home care for dementia patients. Int. J. Geriat. Psychiatry 12: 671–677.Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Laura E. Gibbons
    • 1
  • Linda Teri
    • 1
  • Rebecca Logsdon
    • 1
  • Susan M. McCurry
    • 1
  • Walter Kukull
    • 1
  • James Bowen
    • 1
  • Wayne McCormick
    • 1
  • Eric Larson
    • 1
  1. 1.Department of Psychosocial and Community HealthUniversity of WashingtonSeattle

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