Environmental correlates of neuropsychiatric symptoms in nursing home patients with dementia
Abstract
Objective: The aim of the study was to estimate the influence of environmental correlates of neuropsychiatric symptoms in nursing home patients with dementia. Methods: 1289 patients in 56 Dementia Special Care Units (SCUs) in the Netherlands were assessed using the Neuropsychiatric Inventory–Nursing Home version (NPI–NH) and the Cohen‐Mansfield Agitation Inventory (CMAI). Potential correlates of the neuropsychiatric symptoms studied were gender and age of the patient, dementia severity, psychoactive medication use and environmental correlates such as the number of patients per unit or per living room, staff size/patient ratio, time spent on care activities and presence of a walking circuit. Multilevel logistic regression analysis was used to estimate the relative contribution of the different factors in explaining neuropsychiatric symptoms variability. Results: The prevalence of neuropsychiatric symptoms differed between SCUs, also after correcting for patient factors. Patient‐related factors explained 7–21% of the total variance of neuropsychiatric symptoms. Intra Class Correlation (the correlation of symptoms of patients within SCUs) ranged from 0.039 (psychosis) to 0.163 (apathy). The variance in SCU symptom prevalence (variance between SCUs) accounted for 3.5–14.8% of the total variance in neuropsychiatric symptoms. In SCUs of which the staff spent more time on care activities did the patients show lower levels of apathy. Other environmental correlates did not predict neuropsychiatric symptoms. Conclusion: The substantial variation of prevalence rates between SCUs in combination with the clustering of symptoms within SCUs is strong evidence for the environmental contribution to neuropsychiatric symptoms and the multifactorial nature of behaviour in dementia. Copyright © 2009 John Wiley & Sons, Ltd.
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Eighty-six percent of the studies included patients with different types of dementia, but the remaining 14% investigated only patients with Alzheimer's disease.
“Eighty-six percent of the studies included patients with different types of dementia, but the remaining 14% investigated only patients with Alzheimer's disease [35,38,41].”
From Special Care Units and Traditional Care in Dementia: Relationship with Behavior, Cognition, Functional Status and Quality of Life - A Review (2013) · cites this paper as [41]
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- Authors
- Zuidema, S. U., de Jonghe, J. F. M., Verhey, F. R. J., & Koopmans, R. T. C. M.
- Affiliations
- Radboud University Nijmegen (NL)
- Maastricht University Medical Centre (NL)
- Corresponding author
- Zuidema, Sytse U.
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2009-12-15
- Volume
- 25
- Issue
- 1
- Pages
- 14-22
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W2129686111
- Cited by
- 96
- References
- 41
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 9 · 2019: 9 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 5 · 2014: 15 · 2013: 8 · 2012: 7
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- neuropsychiatric symptoms, dementia, nursing homes, dementia special care units, environmental factors, staff-to-patient ratio, care activities, apathy, psychosis, dementia severity, psychotropic drugs
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aggression, Anxiety, Dementia, Depressive Disorder, Female, Homes for the Aged, Humans, Male, Netherlands, Nursing Homes, Psychiatric Status Rating Scales, Psychomotor Agitation, Psychotic Disorders, Sex Factors, Social Environment, Antipsychotic Agents, Apathy
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