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A longitudinal examination of agitation and resident characteristics in the nursing home
- Authors:
- BURGION Louis D., et al
- Journal article citation:
- Gerontologist, 47(5), October 2007, pp.642-649.
- Publisher:
- Oxford University Press
Agitation frequently accompanies cognitive decline among nursing home residents. This study used cross-sectional and longitudinal (up to 18 months) methods to examine agitation among profoundly and moderately impaired residents using both staff report and direct observation methods. The study included participants (N = 78) from a larger study recruited from the Pittsburgh area who completed either 12 or 18 months of data collection. There were four measurement points, each separated by 6-month intervals. Agitation was recorded using two measures: (a) the computer-assisted behavioural observation system (CABOS) and (b) the staff-completed Nursing Home Behavior Problem Scale. Longitudinal hierarchical linear modelling was used to capture the dynamic nature of behaviour change as a function of individual resident characteristics and time. The profoundly cognitively impaired residents displayed more agitation than the moderately impaired group at Epoch 1 (cross-sectional analyses). Longitudinal analysis found a significant linear and quadratic trend only with the profoundly impaired residents using the CABOS. These residents showed slight improvements in agitation up to 12 months, with agitation increasing significantly from 12 to 18 months. With nursing homes receiving an increasing number of profoundly cognitively impaired residents, these results have potential cost and policy implications. Measuring agitation over time by using both staff report and observation measures presents various problems, and the authors present an alternative measure that may help to avoid these difficulties.