Dementia among older adults living in long-term care facilities: an epidemiological study

Fagundes, Daniel Ferreira; Costa, Marcos Túlio; Alves, Bárbara Bispo da Silva; Carneiro, Lara; Nascimento, Osvaldo Jose Moreira; Leão, Luana Lemos; Guimarães, André Luiz Sena; Paula, Alfredo Maurício Batista de; Monteiro-Junior, Renato Sobral

doi:10.1590/1980-57642021dn15-040007

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 15 (04) • Oct-Dec 2021 • https://doi.org/10.1590/1980-57642021dn15-040007 copy

Dementia among older adults living in long-term care facilities: an epidemiological study

Demência em idosos residentes em instituições de longa permanência: um estudo epidemiológico

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Institutionalization has been associated with social isolation, psychological and cognitive changes, and decreased levels of physical activity in older adults.

Objectives:

The aim of this study was to estimate the prevalence of dementia, mild cognitive impairment (MCI), and functional dependence in older adults dwelling in two different Brazilian long-term care facilities (LTCFs).

Methods:

This is a cross-sectional study with 185 older people of both sexes, aged 60 years or over, residing in two LTCFs in the city of Montes Claros-MG, Brazil. The diagnosis of MCI and dementia was performed using the Diagnostic and Statistical Manual of Mental Disorders.

Results:

Prevalence rates of dementia, MCI, and functional dependence in institutionalized older participants were 62.3, 15.1, and 78.9%, respectively. There was a significant reduction of the Mini-Mental State Examination scores according to the increase of the institutionalization period in LCTFs and the age of older adults (p<0.001).

Conclusions:

Prevalence of dementia and functional dependence of older adults residing in LTCFs exhibited higher rates compared to the other older population worldwide. A higher institutionalization period is related to a greater cognitive decline.

Keywords:
elderly; homes for the aged; dementia; mild cognitive impairment

	n	Mean	SD	Min	Max
Age (years)	184	79.59	9.64	60	108
Institutionalization (months)	167	78.66	133.36	0	691
MMSE (score)	157	9.78	7.32	0	28
Barthel (score)	185	46.73	35.13	0	100

Level of education	Female		Male		Total
Level of education	n	%	n	%	Total
Unlettered	41	60.3	27	39.7	68
1–7 years	27	44.26	34	55.73	61
≥8 years	5	50	5	50	10
Total	73	52.51	66	47.48	139

	n=185	%
Dementia	99	62.3
MCI	24	15.1
Functional dependence	146	78.9
Level of dependence
Mild dependence	35	18.9
Moderate dependence	25	13.5
Severe dependence	30	16.2
Total dependence	56	30.3

Age	Dementia	MCI	Functional dependence
60–69	51.70%	20.70%	65.60%
70–79	57.10%	21.40%	73.40%
80–89	70.60%	9.80%	85.20%
90–99	66.70%	5.60%	90.90%
100–110	75%	0%	100%

Level of dependence		OR	p-value	95%CI
Total dependence	Age (years)	1.07	0.01	1.02–1.13
	Sex	0.44	0.09	0.16–1.16
	Impaired cognition	6.21	0.01	1.51–25.53
Severe dependence	Age (years)	1.05	0.11	0.98–1.11
	Sex	0.71	0.53	0.24–2.07
	Impaired cognition	1.13	0.83	0.35–3.60
Moderate dependence	Age (years)	1.06	0.04	1.00–1.13
	Sex	0.68	0.51	0.21–2.16
	Impaired cognition	1.32	0.66	0.36–4.74
Mild dependence	Age (years)	1.05	0.07	0.99–1.11
	Sex	0.47	0.15	0.17–1.31
	Impaired cognition	0.87	0.80	0.29–2.55

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Renato Sobral Monteiro-Junior. Av. Doutor Rui Braga s/n – Vila Mauricéia – 39401-089 Montes Claros MG – Brazil. E-mail: renato.monteiro@unimontes.br