This study will establish prevalence and incidence of specific mental disorders and cognitive impairment among 550 patients newly admitted to 8 nursing homes. Mental morbidity will be determined according to DSM III criteria, and the effect of such disorders and cognitive impairment on adjustment in the nursing home over time, including functioning and satisfaction, will be examined. Data will be obtained at three points in time (two weeks, two months, and one year post-admission) and will include psychiatric evaluations, information from nursing home staff concerning patients' social and physical functioning, and telephone interviews with a family member or responsible person with regard to community social support networks and events prior to institutionalization. For patients discharged alive during the year, information will be sought on status at 12 months post admission (deceased, in another nursing home, in a community residence), including a report of mental status. Death certificate information will be obtained for persons who die during the year. In addition to a rigorous assessment of mental morbidity over time, the study will explore the mitigating effect of social supports and utilization of services on adjustment and satisfaction associated with mental disorders, and the influence of these factors on discharge and mortality. The importance of rigorous differential diagnosis of mental morbidity in understanding the career of nursing home residents cannot be overstated, for improving the quality of lie through more appropriate treatment, and through the design of interventions aimed at improving outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG006765-03
Application #
3117825
Study Section
(LCRB)
Project Start
1986-08-01
Project End
1990-07-31
Budget Start
1988-08-01
Budget End
1989-07-31
Support Year
3
Fiscal Year
1988
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Type
Schools of Public Health
DUNS #
045911138
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Burton, L C; Rovner, B W; German, P S et al. (1995) Neuroleptic use and behavioral disturbance in nursing homes: a 1-year study. Int Psychogeriatr 7:535-45
Burton, L C; German, P S; Rovner, B W et al. (1992) Physical restraint use and cognitive decline among nursing home residents. J Am Geriatr Soc 40:811-6
German, P S; Rovner, B W; Burton, L C et al. (1992) The role of mental morbidity in the nursing home experience. Gerontologist 32:152-8
Burton, L C; German, P S; Rovner, B W et al. (1992) Mental illness and the use of restraints in nursing homes. Gerontologist 32:164-70
Rovner, B W; David, A; Lucas-Blaustein, M J et al. (1988) Self-care capacity and anticholinergic drug levels in nursing home patients. Am J Psychiatry 145:107-9