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Nursing home placement associated with accelerated cognitive decline in Alzheimer's disease

(CHICAGO) People with Alzheimer's disease experience an acceleration in the rate of cognitive decline after being placed in a nursing home according to a new study by Rush University Medical Center. The study, published in the June issue of the American Journal of Psychiatry, finds that prior experience in adult day care may lessen this association.

The observational study involved 432 older persons with Alzheimers disease who were recruited from health care settings in the Chicago area. At baseline, they lived in the community and 196 participants were using day care services from 2 to 6 days a week for an overall mean of 1.7 days a week. At six month intervals for up to four years, they completed nine cognitive tests from which a composite measure of global cognition was derived.

On average, cognition declined at a gradually increasing rate for all participants. During the study period, 155 persons were placed in a nursing home, and placement was associated with a lower level of cognition and more rapid cognitive decline.

Study participants who had previous adult day care experience fared better. As level of day care use at study onset increased, the association of nursing home placement with accelerated cognitive decline substantially decreased. Thus, people using day care 3 to 4 days a week at the beginning of the study showed no increase in cognitive decline upon nursing home placement.

"The findings suggest that experience in day care may help individuals with Alzheimer's disease make the transition from the community to institutional residence," said study author Robert S. Wilson, Ph.D., a neuropsychologist at the Rush Alzheimer's Disease Center.

The study also found that a higher level of education was associated with accelerated cognitive decline upon nursing home placement. Yet, day care use markedly reduced the association of education with accelerated cognitive decline in the nursing home; furth
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Contact: Kim Waterman
Kimberly_Waterman@rush.edu
312-942-7820
Rush University Medical Center
1-Jun-2007


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