Clinical,Demographic, and Pharmacologic Features of Nursing Home Residents With Huntington's Disease |
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| Affiliation: | 1. Omnicare, Inc, Cincinnati, OH;2. Struthers Parkinson''s Center, Golden Valley, MN;3. Hennepin County Medical Center, Minneapolis, MN;1. Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA;2. Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA;3. Department of Psychology, University of Iowa, Iowa City, IA, USA;4. Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA;5. College of Nursing, University of Iowa, Iowa City, IA, USA;6. Departments of Electrical and Computer Engineering and Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, IA, USA;7. Division of Neurobiology, Departments of Psychiatry, Neurology, Neuroscience and Pharmacology, Johns Hopkins University, Baltimore, MD, USA;8. Department of Radiology, School of Medicine, University of California, San Diego, CA, USA;9. Veterans Affairs San Diego Healthcare System, San Diego, CA, USA;10. Center of Excellence for Ethics, Humanities & Spirituality, Texas Tech University Health Sciences Center, School of Medicine, Lubbock, TX, USA;11. Department of Psychiatry and Human Behavior, Division of Biology and Medicine, Alpert Medical School, Brown University, Providence, RI, USA;12. Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA;13. Center for Integrative Brain Research, Seattle Children''s Research Institute, Seattle, WA, USA;14. Department of Biostatistics, Fairbanks School of Public Health, and Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA;15. Advanced Biomedical Informatics Group, Iowa City, IA, USA;p. Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK;1. Indiana University Center for Aging Research, Regenstrief Institute, Indianapolis, IN;2. University of Minnesota, School of Nursing, Minneapolis, MN;1. Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA;2. Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL;3. RTI International, Waltham, MA;4. Rehabilitation Institute of Chicago, Chicago, IL;5. Center for Healthcare Studies, Northwestern University, Chicago, IL;1. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan;2. Department of Nursing, Meiho University, Pingtung, Taiwan;3. School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan;4. Traumatological Division, Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan;5. Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan;6. Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan;7. Fit Great Clinic, Taipei, Taiwan;8. Section of General Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan |
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| Abstract: | BackgroundThe purpose of this descriptive, retrospective analysis was to develop a demographic and clinical profile of nursing home residents with a diagnosis of Huntington's disease (HD).MethodsQueries were made of a large data repository of linked and de-identified Minimum Data Set version 3.0 and prescription claims records, for the time period of October 1, 2010 through March 31, 2012.ResultsOf 249,811 residents, 340 (0.14%) had a diagnosis of HD; 61% were female and 77.9% were Caucasian. The age range mode was 55–59 years (15%). Approximately one-half of the residents with HD exhibited communication difficulties, 78% had moderate or severe cognitive impairment, and most have significant functional limitations. Depression, dementia, anxiety, psychosis, and bipolar disease were present in 59.4%, 50.9%, 35.9%, and 23.2%, and 9.7%, respectively. Only 21% of residents with HD exhibited troublesome behavioral symptoms. Comorbidities of diabetes and cancer were uncommon (0.3%). Use of physical restraints (excluding bed rails) was considerably higher in residents with HD than in the general nursing home population. Falls were documented in almost one-half of residents. Antipsychotics were used in 61.6% of residents; 16.2% had psychotic symptoms. One was treated with tetrabenazine. Anxiolytics were received by 59.1% of residents, whereas only 35.9% had anxiety noted on Minimum Data Set records.ConclusionsThe prevalence of HD in US nursing homes is very low (0.14%). Affected residents have significant cognitive and functional impairments, but problematic behaviors are present in only a minority. Serious comorbidities such as cancer and diabetes are rare. Antipsychotics, antidepressants, and anxiolytics are the mainstays of treatment. |
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| Keywords: | Nursing home Huntington's disease |
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