National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Pressure (1)
- Caregiving (4)
- Chronic Conditions (2)
- (-) Dementia (16)
- Diagnostic Safety and Quality (2)
- Elderly (13)
- Home Healthcare (1)
- Hospital Readmissions (2)
- Long-Term Care (5)
- Medicare (3)
- Medication (3)
- Mortality (1)
- Neurological Disorders (6)
- Nursing Homes (6)
- Palliative Care (1)
- Patient Experience (1)
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- Public Reporting (1)
- Racial and Ethnic Minorities (1)
- Stress (1)
- Telehealth (1)
- Transitions of Care (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedFashaw-Walters SA, McCreedy E, Bynum JPW
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
Investigators examined how race and Alzheimer's and related dementia (ADRD) status influenced the rate of schizophrenia diagnoses among nursing home (NH) residents following the CMS National Partnership to Improve Dementia Care. Using 2011-2015 Minimum Data Set 3.0 assessments, they found that, following the partnership, black NH residents with ADRD were more likely to have a schizophrenia diagnosis documented on their minimum data set assessments, and schizophrenia rates increased for black NH residents with ADRD only.
AHRQ-funded; HS000011.
Citation: Fashaw-Walters SA, McCreedy E, Bynum JPW .
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
J Am Geriatr Soc 2021 Dec;69(12):3623-30. doi: 10.1111/jgs.17464..
Keywords: Elderly, Dementia, Nursing Homes, Racial and Ethnic Minorities, Long-Term Care
Orth J, Li Y, Simning A
Nursing home residents with dementia: association between place of death and patient safety culture.
This study examined the association of place of death and patient safety culture among nursing home (NH) residents with dementia. The authors examined the estimated effects of patient safety culture (PSC) among 11,957 long-stay NH residents with dementia, aged 65+ who died in NHs or hospitals shortly following discharge from one of 800 US NHs in 2017. Residents with dementia in NHs with higher PSC scores in communication openness had lower odds of in-hospital death, with the strongest effect in NHs located in states with higher minimum NH nurse staffing requirements.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
Nursing home residents with dementia: association between place of death and patient safety culture.
Gerontologist 2021 Nov 15;61(8):1296-306. doi: 10.1093/geront/gnaa188..
Keywords: Elderly, Dementia, Nursing Homes, Mortality, Patient Safety
Armstrong MJ, Gamez N, Alliance S
Clinical care and unmet needs of individuals with dementia with Lewy bodies and caregivers: an interview study.
Investigators researched the clinical care preferences of individuals living with dementia and caregivers, particularly dementia with Lewy bodies (DLB). Twenty individuals with DLB and 25 caregivers were interviewed via a semistructured questionnaire. The investigators concluded that improving care for individuals with DLB and their families will require a multipronged strategy including education for non-specialist care providers, increasing specialty care access, improved clinical care services, research to support disease prognosis and treatment decisions, and local and national strategies for enhanced caregiver support.
Citation: Armstrong MJ, Gamez N, Alliance S .
Clinical care and unmet needs of individuals with dementia with Lewy bodies and caregivers: an interview study.
Alzheimer Dis Assoc Disord 2021 Oct-Dec;35(4):327-34. doi: 10.1097/wad.0000000000000459..
Keywords: Dementia, Caregiving, Chronic Conditions, Neurological Disorders, Patient Experience
Ma C, McDonald MV, Feldman PH
Continuity of nursing care in home health: impact on rehospitalization among older adults with dementia.
The objective of this retrospective cohort study was to examine the association between continuity of nursing care in home health care (HHC) and rehospitalization among persons with dementia (PWD). Multiple years of HHC assessment, administrative, and human resources data from a large urban not-for-profit home health agency was used. Findings showed that wide variations exist in continuity of nursing care to PWD. Consistency in nurse staff when providing HHC visits to PWD is critical for preventing rehospitalizations.
AHRQ-funded; HS023593.
Citation: Ma C, McDonald MV, Feldman PH .
Continuity of nursing care in home health: impact on rehospitalization among older adults with dementia.
Med Care 2021 Oct;59(10):913-20. doi: 10.1097/mlr.0000000000001599..
Keywords: Elderly, Home Healthcare, Dementia, Neurological Disorders, Hospital Readmissions
Abrahamson K, Davila H, Kirk L
Can a nursing home psychotropic reduction project be successfully implemented in assisted living?
This study’s objective was to compare implementation of a psychotropic medication reduction project across nursing homes (NH) and assisted living (AL) facilities. Fifteen NHs and 14 AL facilities within a single corporate chain participated. In-person and telephone interviews with 62 staff members from participating NH and AL facilities were conducted to investigate project implementation experience. Implementation at nursing homes made more dramatic changes in residents’ lives and medication use than at assisted living facilities. AL staff identified numerous barriers to implementation.
AHRQ-funded; HS018464.
Citation: Abrahamson K, Davila H, Kirk L .
Can a nursing home psychotropic reduction project be successfully implemented in assisted living?
J Appl Gerontol 2021 Sep;40(9):1071-79. doi: 10.1177/0733464820948328..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medication, Dementia
Hua CL, Thomas KS, Bunker J
Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia.
The objective of this study was to examine the agreement between a clinical Minimum Data Set measure of dementia and a diagnosis of dementia documented on a hospital claim across three points in time. A second objective was to examine the extent to which the agreement varied by age, sex, and race/ethnicity. Findings showed that hospital claims for patients aged 66–75 were less likely to be accurate than those for other age groups and suggests that physicians do not always look for signs of dementia in younger adults. Additionally, Asian patients were less likely to have a diagnosis of dementia documented during hospitalization, which could be related to language barriers between patients and clinicians.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS, Bunker J .
Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia.
J Am Geriatr Soc 2021 Sep;69(9):2672-75. doi: 10.1111/jgs.17201..
Keywords: Elderly, Dementia, Neurological Disorders, Diagnostic Safety and Quality, Medicare
Hoffman GJ, U U, Bynum J
Alzheimer's disease and related dementias and episode spending under Medicare's Bundled Payment for Care Improvements Advanced (BPCI-A).
Investigators evaluated the prevalence of Alzheimer’s disease and related dementias (ADRD) across the episodes included in Medicare's Bundled Payments for Care Improvement Advanced (BPCI-A) program and the association between ADRD and 90-day spending among hospitals participating in the BPCI-A program. They found that ADRD is associated with higher episode spending, highlighting the importance of closely monitoring the experience of these patients under BPCI-A to ensure that they are receiving appropriate care. This is particularly important for episodes like sepsis and pneumonia that are common among patients with ADRD and also highly prevalent under BPCI-A.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, U U, Bynum J .
Alzheimer's disease and related dementias and episode spending under Medicare's Bundled Payment for Care Improvements Advanced (BPCI-A).
J Gen Intern Med 2021 Aug;36(8):2499-502. doi: 10.1007/s11606-020-06348-2..
Keywords: Elderly, Dementia, Medicare, Payment
Shepard V, Chou LN, Kuo YF, et al.
Characteristics associated with feeding tube placement: retrospective cohort study of Texas nursing home residents with advanced dementia.
The purpose of this retrospective cohort study was to investigate resident-level, provider-type, nursing home (NH), and regional factors associated with feeding tube (FT) placement in advanced dementia. The investigators concluded that regional, race, and ethnic variations in prevalence of FT use among NH residents suggested opportunities for clinicians and policy makers to improve the quality of end-of-life care by especially considering other palliative care measures for minorities living in border towns.
AHRQ-funded; HS020642.
Citation: Shepard V, Chou LN, Kuo YF, et al..
Characteristics associated with feeding tube placement: retrospective cohort study of Texas nursing home residents with advanced dementia.
J Am Med Dir Assoc 2021 Jul;22(7):1471-76.e4. doi: 10.1016/j.jamda.2020.10.033..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders
Orth J, Li Y, Simning A
End-of-life care among nursing home residents with dementia varies by nursing home and market characteristics.
This study’s objectives were to examine variations in end-of-life (EOL) care/outcomes among decedents with Alzheimer's disease/related dementias (ADRD) and to identify associations with nursing home (NH)/market characteristics. Findings showed that decedents with ADRD in NHs that were nonprofit, had Alzheimer's units, higher licensed nurse staffing, and in more competitive markets, had better EOL care/outcomes. Recommendations included modifications to state Medicaid NH payments to promote better EOL care/outcomes and future research to understand NH care practices associated with presence of Alzheimer's units in order to identify mechanisms possibly promoting higher-quality EOL care.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
End-of-life care among nursing home residents with dementia varies by nursing home and market characteristics.
J Am Med Dir Assoc 2021 Feb;22(2):320-28.e4. doi: 10.1016/j.jamda.2020.06.021..
Keywords: Elderly, Palliative Care, Dementia, Nursing Homes, Long-Term Care
van Dalen JW, Marcum ZA, Gray SL
Association of angiotensin II-stimulating antihypertensive use and dementia risk: post hoc analysis of the PreDIVA trial.
The purpose of this study was to assess whether angiotensin II-stimulating antihypertensives (thiazides, dihydropyridine calcium channel blockers, and angiotensin I receptor blockers) convey a lower risk of incident dementia compared to angiotensin II-inhibiting antihypertensives (angiotensin-converting enzyme inhibitors, β-blockers, and nondihydropyridine calcium channel blockers), in accordance with the "angiotensin hypothesis." The investigators concluded that users of angiotensin II-stimulating antihypertensives had lower dementia rates compared to angiotensin II-inhibiting antihypertensive users, supporting the angiotensin hypothesis.
AHRQ-funded; HS022982.
Citation: van Dalen JW, Marcum ZA, Gray SL .
Association of angiotensin II-stimulating antihypertensive use and dementia risk: post hoc analysis of the PreDIVA trial.
Neurology 2021 Jan 5;96(1):e67-e80. doi: 10.1212/wnl.0000000000010996.
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Keywords: Medication, Dementia, Blood Pressure
Armstrong Armstrong, Irwin DJ, Leverenz JB
Biomarker use for dementia with Lewy body diagnosis: survey of US experts.
Researchers investigated clinical practice patterns of dementia with Lewy body (DLB) diagnostic criteria. An anonymous survey was sent to 38 center of excellence investigators inquiring about clinical use of diagnostic tests/biomarkers. They found that neuropsychological testing and MRI remained the most widely used diagnostic tests by DLB specialists. Other tests, particularly, indicative biomarkers, are used only selectively. They recommended research to validate existing potential DLB biomarkers, to develop new biomarkers, and to investigate mechanisms to improve DLB diagnosis.
Citation: Armstrong Armstrong, Irwin DJ, Leverenz JB .
Biomarker use for dementia with Lewy body diagnosis: survey of US experts.
Alzheimer Dis Assoc Disord 2021 Jan-Mar;35(1):55-61. doi: 10.1097/wad.0000000000000414..
Keywords: Dementia, Neurological Disorders, Diagnostic Safety and Quality
Zmora R, Zmora LL, Bustamante G
Dementia caregivers' experiences and reactions to remote activity monitoring system alerts.
Technology-based tools, including remote activity monitoring (RAM) systems, have been proposed as valuable aids for family caregivers of people with dementia. Previous analyses have shown limited effects of these systems and highlighted a number of barriers, including false alarms. In this study, the investigators used data from an ongoing embedded mixed method randomized controlled intervention to describe patterns of alerts and their association with receipt of the RAM system and caregiver outcomes.
AHRQ-funded; HS022836.
Citation: Zmora R, Zmora LL, Bustamante G .
Dementia caregivers' experiences and reactions to remote activity monitoring system alerts.
J Gerontol Nurs 2021 Jan;47(1):13-20. doi: 10.3928/00989134-20201208-03.
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Keywords: Elderly, Dementia, Neurological Disorders, Caregiving, Telehealth
Zmora R, Statz TL, Birkeland RW
Transitioning to long-term care: family caregiver experiences of dementia, communities, and counseling.
Previous analyses of interventions targeting relationships between family caregivers of people with Alzheimer's disease and related dementias and residential long-term care (RLTC) staff showed modest associations with caregiver outcomes. This analysis aimed to better understand interpersonal and contextual factors that influence caregiver-staff relationships and identify targets for future interventions to improve these relationships.
AHRQ-funded; HS022836.
Citation: Zmora R, Statz TL, Birkeland RW .
Transitioning to long-term care: family caregiver experiences of dementia, communities, and counseling.
J Aging Health 2021 Jan;33(1-2):133-46. doi: 10.1177/0898264320963588..
Keywords: Elderly, Caregiving, Dementia, Transitions of Care, Long-Term Care, Chronic Conditions
Austrom MG, Lu YY, Perkins AJ
Impact of noncaregiving-related stressors on informal caregiver outcomes.
The researchers studied the most stressful events experienced by spouse caregivers of older adults with Alzheimer s disease during a 6-month period. They found that caregivers reported no stressors 21.5% of the time, 1-2 stressors 25% of the time, and 3 stressors 53% of the time with 318 stressors reported in total. They concluded that their results can be used to develop targeted intervention and support strategies for spouse caregivers experiencing non-caregiving related stressors as well as the traditional challenges with caregiving-related issues.
AHRQ-funded; HS010884.
Citation: Austrom MG, Lu YY, Perkins AJ .
Impact of noncaregiving-related stressors on informal caregiver outcomes.
Am J Alzheimers Dis Other Demen 2014 Aug;29(5):426-32. doi: 10.1177/1533317513518652.
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Keywords: Caregiving, Dementia, Elderly, Stress
Daiello LA, Gardner R, Epstein-Lubow G
Association of dementia with early rehospitalization among Medicare beneficiaries.
This study examined the question of whether dementia was associated with a greater likelihood of Medicare patients being readmitted to the hospital within 30 days. Using a group of 25,839 hospitalizations, including 3,908 admissions of Me.icare beneficiaries with dementia, it found that those with a dementia diagnosis were more likely (17.8 percent vs. 14.5 percent) to be readmitted within 30 days.
AHRQ-funded; HS017735.
Citation: Daiello LA, Gardner R, Epstein-Lubow G .
Association of dementia with early rehospitalization among Medicare beneficiaries.
Arch Gerontol Geriatr. 2014 Jul-Aug;59(1):162-8. doi: 10.1016/j.archger.2014.02.010..
Keywords: Medicare, Elderly, Dementia, Hospital Readmissions
Konetzka RT, Brauner DJ, Shega J
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The purpose of this paper was to assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Shega J .
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
J Am Geriatr Soc 2014 Mar;62(3):454-61. doi: 10.1111/jgs.12711.
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Keywords: Dementia, Elderly, Medication, Nursing Homes, Public Reporting