In a Johns Hopkins study, two-thirds of assisted
living residents in central Maryland were diagnosed with
dementia, and more than one-quarter of residents had other
psychiatric ailments, such as depression, anxiety disorder
or psychosis.
"These high rates indicate that many assisted living
residents with dementia go undiagnosed and are not
adequately treated," says Adam Rosenblatt, assistant
professor of
psychiatry at Johns Hopkins and lead
author of the report appearing in the October issue of the
Journal of the American Geriatric Association.
"This situation contrasts sharply with the goals of
the assisted living movement, but it can be alleviated to
some degree by providing psychiatric care to residents,
ongoing consultation and specialized nursing staff with
training in dementia," Rosenblatt says.
For elderly people unable to live alone, assisted
living programs aim to provide a stable residence, maximize
quality of life and support their ability to age in place
without discharge to a nursing home or hospital.
The Maryland Assisted Living Study is an ongoing,
long-term investigation that aims to obtain a direct
estimate of the prevalence of dementia and other
psychiatric disorders in assisted living residents and to
determine the effect of these disorders on residents. The
study was designed to provide information to health
providers, policy-makers, regulators, the assisted living
industry and the general public.
The investigators reviewed health history and
psychiatric evaluations in a randomized sample of assisted
living residents in 22 randomly selected assisted living
facilities, 10 of them large and 12 small, in Baltimore
City and seven Maryland counties. One hundred ninety-eight
volunteers participated in the study; 75 percent were 80
years and older, and 78 percent were female. Overall rates
of dementia and other psychiatric diseases were measured
and adequate treatment history reviewed by an expert
multidisciplinary panel.
The researchers found that two-thirds (67.7 percent)
of participants had dementia as defined by the Diagnostic
and Statistical Manual of Mental Disorders. Eighty-one
percent of those in small facilities (less than 15 beds)
and 63 percent in large facilities (more than 15 beds) had
dementia. More than one-quarter (26.3 percent) had another
psychiatric disorder, such as depression, anxiety disorder
or psychosis. Seventy-three percent of dementias were
adequately evaluated, but only 52 percent were adequately
treated. Of those who had other psychiatric disorders, up
to 61 percent were recognized, but only 52 percent were
adequately treated.
By 1999 approximately 600,000 senior citizens in the
United States were residents of assisted living facilities.
An additional 1.5 million Americans resided in nursing
homes.
Other authors of the report are Quincy Samus, Cynthia
Steele, Alva Baker, Michael Harper, Jason Brandt, Peter
Rabins and Constantine Lyketsos. The study was funded by
the National Institute of Mental Health.
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