Social Engagement and Antipsychotic Use in Addressing the Behavioral and Psychological Symptoms of Dementia in Long-Term Care Facilities

Abstract

Objectives The use of antipsychotics, mainly to address the behavioral and psychological symptoms of dementia (BPSD), remains a common and frequent practice in long-term care facilities (LTCFs) despite their associated risks. The objective of this study was to explore the association between social engagement (SE) and the use of antipsychotics in addressing the BPSD in newly admitted residents to LTCFs. Methods A cross-sectional study was undertaken using administrative data, primarily the Resident Assessment Instrument Minimum Data Set (Version 2.0) that collected between 2008 and 2011 (Fraser Health region, British Columbia, Canada). The data analysis conducted on a sample of 2,639 newly admitted residents aged 65 or older with a diagnosis of Alzheimer's disease or other dementias as of their first full or first quarterly assessment. Multivariate logistic regression analyses were undertaken to predict antipsychotic use based on SE. Results SE was found to be a statistically significant predictor of antipsychotic use when controlling for sociodemographic variables (odds ratio ( OR) = .86, p < .0001, confidence interval (CI) [0.82, 0.90]). However, the association disappeared when controlling for health variables ( OR = .97, p = .21, CI [0.97, 1.0]). Conclusion The prediction of antipsychotic use in newly admitted residents to LTCFs by SE is complex. Further research is warranted for further examination of the association of antipsychotic use in newly admitted residents to LTCFs.

Clinical impact of antipsychotic and benzodiazepine reduction: findings from a multicomponent psychotropic reduction program within long-term aged care

“…Maximization of QoL is a major goal within the LTCF setting (Saleh et al, 2017). The perceived potential for antipsychotic discontinuation to negatively affect QoL is a major barrier to altering these medications among nurses and GPs (Azermai et al, 2014).…”

“…However, there is some evidence from placebo-controlled trials suggesting that most people can be withdrawn from these agents without any increased risk of harm (Van Leeuwen et al, 2018). Furthermore, there is evidence that reduced sedation may confer benefits to the resident, including improved levels of social engagement (Saleh et al, 2017).…”

Health effects of social connectedness in older adults living in congregate long‐term care settings: A systematic review of quantitative and qualitative evidence

“…Eight studies were a secondary analysis of data from a previous study (Cho et al, 2012; Choi et al, 2018; Hsiao & Chen, 2018; Lee et al, 2017; McCabe et al, 2021; Morrison‐Koechl et al, 2021; Randall et al, 2011; Smit et al, 2016). Nine studies (Beck & Ovesen, 2003; Chen et al, 2009; Degenholtz et al, 2006; Hjaltadóttir et al, 2012; Kang, 2012; Li et al, 2015; Saleh et al, 2017; Smit et al, 2016; Vanbeek et al, 2011) used the Minimum Data Set data and administrative data. For the studies collecting primary data, most had trained members of the research team to conduct structured interviews (face‐to‐face) or distribute self‐administered surveys and six studies (Björk et al, 2017; Chen et al, 2000; Cohen‐Mansfield & Marx, 1992; Damian et al, 2008; Fernández‐Mayoralas et al, 2015; Marventano et al, 2015) relied on nursing home staff to collect information on the residents.…”

Prevalência e fatores associados ao uso de psicotrópicos em idosos: uma revisão integrativa

“…Porém os resultados dos estudos confirmaram que a história de diagnóstico médico de depressão é o fator mais relacionado ao uso de psicofármacos, além do uso de tratamentos para demência e Alzheimer. Um achado interessante segundo Saleh et. al., (2017) é de que residentes de instituições de cuidados de longa permanência em cerca de 31, 8% não apresentavam nenhum perfil de agressividade e mesmo assim receberam medicamento antipsicóticos, enquanto 27,5% desses residentes com quadro de agressividade severa de comportamento não recebeu antipsicóticos.…”