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12-month incidence, prevalence, persistence, and treatment of mental disorders among individuals recently admitted to assisted living facilities in Maryland

Published online by Cambridge University Press:  07 January 2013

Quincy M. Samus*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Chiadi U. Onyike
Affiliation:
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Deirdre Johnston
Affiliation:
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Lawrence Mayer
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Matthew McNabney
Affiliation:
Department of Medicine, Johns Hopkins Bayview Medical Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Alva S. Baker
Affiliation:
The Center for the Study of Aging, McDaniel College, Westminster, Maryland, USA
Jason Brandt
Affiliation:
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Peter V. Rabins
Affiliation:
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Constantine G. Lyketsos
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Adam Rosenblatt
Affiliation:
Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
*
Correspondence should be addressed to: Quincy M. Samus, PhD, MS, Assistant Professor of Psychiatry, The Johns Hopkins School of Medicine, 5300 Alpha Commons Drive, 4th Floor, Baltimore, MD 21224, USA. Phone: +1-410-550-6744; Fax: +1-410-550-1407. Email: qmiles@jhmi.edu.

Abstract

Background: To estimate the 12-month incidence, prevalence, and persistence of mental disorders among recently admitted assisted living (AL) residents and to describe the recognition and treatment of these disorders.

Methods: Two hundred recently admitted AL residents in 21 randomly selected AL facilities in Maryland received comprehensive physician-based cognitive and neuropsychiatric evaluations at baseline and 12 months later. An expert consensus panel adjudicated psychiatric diagnoses (using DSM-IV-TR criteria) and completeness of workup and treatment. Incidence, prevalence, and persistence were derived from the panel's assessment. Family and direct care staff recognition of mental disorders was also assessed.

Results: At baseline, three-quarters suffered from a cognitive disorder (56% dementia, 19% Cognitive Disorders Not Otherwise Specified) and 15% from an active non-cognitive mental disorder. Twelve-month incidence rates for dementia and non-cognitive psychiatric disorders were 17% and 3% respectively, and persistence rates were 89% and 41% respectively. Staff recognition rates for persistent dementias increased over the 12-month period but 25% of cases were still unrecognized at 12 months. Treatment was complete at 12 months for 71% of persistent dementia cases and 43% of persistent non-cognitive psychiatric disorder cases.

Conclusions: Individuals recently admitted to AL are at high risk for having or developing mental disorders and a high proportion of cases, both persistent and incident, go unrecognized or untreated. Routine dementia and psychiatric screening and reassessment should be considered a standard care practice. Further study is needed to determine the longitudinal impact of psychiatric care on resident outcomes and use of facility resources.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013

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