Journal article
COVID-19 Pandemic Impact on the Trajectories of Cognitive Decline and Depression Symptoms in Long-Term Care Facility Residents
Journal of the American Medical Directors Association, Vol.25(2), pp.328-334.e6
02/2024
DOI: 10.1016/j.jamda.2023.12.003
PMID: 38195079
Abstract
Objectives
To compare the longitudinal rates of change in cognition and depressive symptoms between 2019 (pre–COVID-19 pandemic) and 2020 (COVID-19 pandemic) among long-term care facility (LTCF) residents in Iowa, which ranked among the top 10 US states that suffered from extreme nursing staff shortages during this crisis.
Design
A longitudinal cohort study analyzing the Long-Term Care Minimum Data Set (MDS) version 3.0 between January 1, 2019, and December 31, 2020.
Setting and Participants
LTCF residents from the state of Iowa, with a first assessment before March 10 for each year (2019 and 2020), LTCF stay period >60 days, and at least 2 documented assessments with a minimum of 45 days in between. LTCF residents with a Brief Interview for Mental Status score (BIMS) <3 were excluded.
Methods
We computed doubly robust estimators by combining regression and propensity score models for BIMS (cognitive decline) and Nine-item Patient Health Questionnaire (PHQ-9; depression symptoms) monthly scores for 2020 vs 2019.
Results
A total of 24,025 residents from 436 LTCFs were included. Our research revealed a marginally accelerated monthly decline in BIMS scores during 2020 as opposed to 2019, with a rate of −0.012 per month (95% CI −0.022, −0.002; P = .016). Simultaneously, we observed a monthly increment of 0.016 in the PHQ-9 scores among LTCF residents in 2020 (95% CI 0.006, 0.028; P = .003).
Conclusions and Implications
Our study identified a notable yet modest increase in cognitive decline and depressive symptoms among NH residents in Iowa during the COVID-19 pandemic. Although statistically significant, the changes were small and may not have clinical relevance over 1 year. Further research is needed to examine risk factors for cognitive decline during pandemic scenarios such as social isolation, loneliness, inappropriate patient-centered care, and the relationship with staff shortage and facility resources.
Details
- Title: Subtitle
- COVID-19 Pandemic Impact on the Trajectories of Cognitive Decline and Depression Symptoms in Long-Term Care Facility Residents
- Creators
- Rawabi Aljadani - University of IowaRyan Carnahan - University of IowaKennith Culp - University of IowaJuliana N. Souza-Talarico
- Resource Type
- Journal article
- Publication Details
- Journal of the American Medical Directors Association, Vol.25(2), pp.328-334.e6
- DOI
- 10.1016/j.jamda.2023.12.003
- PMID
- 38195079
- NLM abbreviation
- J Am Med Dir Assoc
- ISSN
- 1525-8610
- eISSN
- 1538-9375
- Language
- English
- Electronic publication date
- 01/2024
- Date published
- 02/2024
- Academic Unit
- Epidemiology; Iowa Neuroscience Institute; Nursing; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984543190002771
Metrics
15 Record Views