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Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents
Authors:Sabine Björk  Hugo Lövheim  Marie Lindkvist  Anders Wimo  David Edvardsson
Affiliation:1. Department of Nursing, Ume? University, Ume?, Sweden;2. Department of Community Medicine and Rehabilitation, Geriatric Medicine, Ume? University, Ume?, Sweden;3. Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Ume? University, Ume?, Sweden;4. Department of Statistics, Ume? School of Business and Economics, Ume? University, Ume?, Sweden;5. Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden;6. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
Abstract:

Objectives

The purpose of this study was to explore relations among thriving, cognitive function, and neuropsychiatric symptoms (NPS) in nursing home residents.

Methods

A national, cross‐sectional, randomized study of Swedish nursing home residents (N = 4831) was conducted between November 2013 and September 2014. Activities of daily life functioning, cognitive functioning, NPS, and thriving were assessed with the Katz activities of daily living, Gottfries' Cognitive Scale, Nursing Home version of the Neuropsychiatric Inventory, and Thriving of Older People Scale, respectively. Individual NPS were explored in relation to cognitive function. Simple linear and multiple regression models were used to explore thriving in relation to resident characteristics.

Results

Aggression and depressive symptoms were identified as negatively associated with thriving regardless of resident cognitive functioning. At higher levels of cognitive functioning, several factors showed associations with thriving; however, at lower levels of cognitive functioning, only the degree of cognitive impairment and the NPS was associated with thriving. Most of the individual NPS formed nonlinear relationships with cognitive functioning with higher symptom scores in the middle stages of cognitive functioning. Exceptions were elation/euphoria and apathy, which increased linearly with severity of cognitive impairment.

Conclusions

The lower the cognitive functioning was, the fewer factors were associated with thriving. Aggression and depressive symptoms may indicate lower levels of thriving; thus, targeting these symptoms should be a priority in nursing homes. Copyright © 2017 John Wiley & Sons, Ltd.
Keywords:neuropsychiatric symptoms  dementia  nursing homes  frail elderly  thriving  quality of life  cross‐sectional study
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