Factors Associated with ADL Dependence in Nursing Home Residents with Korsakoff’s Syndrome and Other Alcohol-Related Disorders: An Explorative Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Outcome Measure (ADL-H)
2.4. Variables
2.5. Statistical Analysis
2.6. Ethical Considerations
3. Results
3.1. Sociodemographic and Clinical Characteristics
3.2. Multivariable Logistic Regression Models
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Arts, N.J.M.; Walvoort, S.J.W.; Kessels, R.P.C. Korsakoff’s Syndrome: A Critical Review. Neuropsychiatr. Dis. Treat. 2017, 13, 2875–2890. [Google Scholar] [CrossRef] [Green Version]
- Gerridzen, I.J. Nothing Is Wrong with Me; Behavioural Symptoms and Awareness in People with Korsakoff Syndrome and Other Alcohol Related Cognitive Disorder Living in Nursing Homes; Gildeprint: Enschede, The Netherlands, 2020; ISBN 978-94-6402-055-7. [Google Scholar]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Dsm-5(r)); Revised editie (22 mei 2013); American Psychiatric Association Publishing: Washington, DC, USA, 2013; ISBN 978-0-89042-554-1. [Google Scholar]
- Singh, S.M. Depression and Dementia. Br. J. Psychiatry 2009, 194, 287. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gerridzen, I.J.; Hertogh, C.M.P.M.; Depla, M.F.; Veenhuizen, R.B.; Verschuur, E.M.L.; Joling, K.J. Neuropsychiatric Symptoms in People with Korsakoff Syndrome and Other Alcohol-Related Cognitive Disorders Living in Specialized Long-Term Care Facilities: Prevalence, Severity, and Associated Caregiver Distress. J. Am. Med. Dir. Assoc. 2018, 19, 240–247. [Google Scholar] [CrossRef] [PubMed]
- Moerman-Van Den Brink, W.G.; Van Aken, L.; Verschuur, E.M.L.; Walvoort, S.J.W.; Egger, J.I.M.; Kessels, R.P.C. Executive Dysfunction in Patients with Korsakoff’s Syndrome: A Theory-Driven Approach. Alcohol Alcohol. 2019, 54, 23–29. [Google Scholar] [CrossRef]
- Kopelman, M.D. The Korsakoff Syndrome. Rev. Clínica Esp. 1995, 76, 79–86. [Google Scholar] [CrossRef] [PubMed]
- Kopelman, M.D.; Thomson, A.D.; Guerrini, I.; Marshall, E.J. The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment. Alcohol Alcohol. 2009, 44, 148–154. [Google Scholar] [CrossRef] [Green Version]
- Victor, M.; Adams, R.D.; Collins, G.H. The Wernicke Korsakoff Syndrome and Related Neurological Disorders Due to Alcoholism and Malnutrition. J. Neurol. Neurosurg. Psychiatry 1989, 52, 1217–1218. [Google Scholar]
- Cheon, Y.; Park, J.; Joe, K.H.; Kim, D.J. The Effect of 12-Week Open-Label Memantine Treatment on Cognitive Function Improvement in Patients with Alcohol-Related Dementia. Int. J. Neuropsychopharmacol. 2008, 11, 971–983. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van Achterberg, T.; Bours, G.J.J.W.; van der Bruggen, H.; van Duurling, R.A.H.; Eland-de Kok, P.C.M.; Habets, H.P.J.M.; Hamers, J.P.H.; Kruijswijk Jansen, J.H.; de Laat, H.E.W.; Lemmens, J.; et al. Effectief Verplegen Deel 1; Van Achterberg, T., Bours, G.J.J.W., Eliens, A.M., Eds.; Kavanah: Dwingeloo, The Netherlands, 2016; ISBN 978-90-5740-146-6. [Google Scholar]
- Mohanty, S.; Gangil, O.P.; Kumar, S. Instrumental Activities of Daily Living and Subjective Wellbeing in Elderly Persons Living in Community. Indian J. Gerontol. 2012, 26, 193–206. [Google Scholar]
- Visser, M.; Pluijm, S.M.F.; Stel, V.S.; Bosscher, R.J.; Deeg, D.J.H. Physical Activity as a Determinant of Change in Mobility Performance: The Longitudinal Aging Study Amsterdam. J. Am. Geriatr. Soc. 2002, 50, 1774–1781. [Google Scholar] [CrossRef] [PubMed]
- Edvardsson, D.; Petersson, L.; Sjogren, K.; Lindkvist, M.; Sandman, P.O. Everyday Activities for People with Dementia in Residential Aged Care: Associations with Person-Centredness and Quality of Life. Int. J. Older People Nurs. 2014, 9, 269–276. [Google Scholar] [CrossRef] [PubMed]
- Morley, J.E.; Philpot, C.D.; Gill, D.; Berg-Weger, M. Meaningful Activities in the Nursing Home. J. Am. Med. Dir. Assoc. 2014, 15, 79–81. [Google Scholar] [CrossRef] [PubMed]
- Henskens, M.; Nauta, I.M.; Drost, K.T.; Milders, M.V.; Scherder, E.J.A. Predictors of Care Dependency in Nursing Home Residents with Moderate to Severe Dementia: A Cross-Sectional Study. Int. J. Nurs. Stud. 2019, 92, 47–54. [Google Scholar] [CrossRef] [PubMed]
- den Ouden, M.; Bleijlevens, M.H.C.; Meijers, J.M.M.; Zwakhalen, S.M.G.; Braun, S.M.; Tan, F.E.S.; Hamers, J.P.H. Daily (In)Activities of Nursing Home Residents in Their Wards: An Observation Study. J. Am. Med. Dir. Assoc. 2015, 16, 963–968. [Google Scholar] [CrossRef]
- Grönstedt, H.; Frändin, K.; Bergland, A.; Helbostad, J.L.; Granbo, R.; Puggaard, L.; Andresen, M.; Hellström, K. Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial. Gerontology 2013, 59, 220–229. [Google Scholar] [CrossRef] [Green Version]
- Wang, D.X.M.; Yao, J.; Zirek, Y.; Reijnierse, E.M.; Maier, A.B. Muscle Mass, Strength, and Physical Performance Predicting Activities of Daily Living: A Meta-Analysis. J. Cachexia Sarcopenia Muscle 2020, 11, 3–25. [Google Scholar] [CrossRef] [Green Version]
- Doroszkiewicz, H.; Sierakowska, M. Factors Associated with Risk of Care Dependency in Disabled Geriatric Patients. Scand. J. Caring Sci. 2021, 35, 134–142. [Google Scholar] [CrossRef] [PubMed]
- Connolly, D.; Garvey, J.; McKee, G. Factors Associated with ADL/IADL Disability in Community Dwelling Older Adults in the Irish Longitudinal Study on Ageing (TILDA). Disabil. Rehabil. 2017, 39, 809–816. [Google Scholar] [CrossRef]
- Morris, J.N.; Berg, K.; Fries, B.E.; Steel, K.; Howard, E.P. Scaling Functional Status within the InterRAI Suite of Assessment Instruments. BMC Geriatr. 2013, 13, 128. [Google Scholar] [CrossRef] [Green Version]
- Hirdes, J.P.; Ljunggren, G.; Morris, J.N.; Frijters, D.H.; Finne Soveri, H.; Gray, L.; Björkgren, M.; Gilgen, R. Reliability of the InterRAI Suite of Assessment Instruments: A 12-Country Study of an Integrated Health Information System. BMC Health Serv. Res. 2008, 8, 277. [Google Scholar] [CrossRef] [Green Version]
- Morris, J.N.; Fries, B.E.; Morris, S.A. Scaling ADLs within the MDS. J. Gerontol.—Ser. Biol. Sci. Med. Sci. 1999, 54, 546–553. [Google Scholar] [CrossRef] [Green Version]
- Morris, J.N.; Fries, B.E.; Mehr, D.R.; Hawes, C.; Phillips, C.; Mor, V.; Lipsitz, L.A. MDS Cognitive Performance Scale. J. Gerontol. 1994, 49, M174–M182. [Google Scholar] [CrossRef] [PubMed]
- Morris, J.N.; Howard, E.P.; Steel, K.; Perlman, C.; Fries, B.E.; Garms-Homolová, V.; Henrard, J.C.; Hirdes, J.P.; Ljunggren, G.; Gray, L.; et al. Updating the Cognitive Performance Scale. J. Geriatr. Psychiatry Neurol. 2016, 29, 47–55. [Google Scholar] [CrossRef] [Green Version]
- Hoofien, D.; Sharoni, L. Measuring Unawareness of Deficits among Patients with Traumatic Brain Injury: Reliability and Validity of the Patient Competency Rating Scale -Hebrew Version. Isr. J. Psychiatry Relat. Sci. 2006, 43, 296–305. [Google Scholar] [PubMed]
- Cummings, J.L.; Mega, M.; Grayâ, K. The Neuropsychiatric Inventory: Comprehensive Assessment of Psychopathology in Dementia. Neurology 1994, 44, 2308–2314. [Google Scholar] [CrossRef] [Green Version]
- Kaufer, D.I. Validation of the NPI-Q, a Brief Clinical Form of the Neuropsychiatric Inventory. J. Neuropsychiatry 2000, 12, 233–239. [Google Scholar] [CrossRef] [PubMed]
- de Jonghe, J.F.M.; Kat, M.G.; Kalisvaart, C.J.; Boelaarts, L. Neuropsychiatric Inventory Questionnaire (NPI-Q): A Validity Study of the Dutch Form. Tijdschr Gerontol Geriatr. 2003, 34, 74–77. [Google Scholar] [PubMed]
- Caro, J.; Ward, A.; Ishak, K.; Migliaccio-Walle, K.; Getsios, D.; Papadopoulos, G.; Torfs, K. To What Degree Does Cognitive Impairment in Alzheimer’s Disease Predict Dependence of Patients on Caregivers? BMC Neurol. 2002, 2, 6. [Google Scholar] [CrossRef] [Green Version]
- Stern, Y.; Albert, S.M.; Sano, M.; Richards, M.; Miller, L.; Folstein, M.; Albert, M.; Bylsma, F.W.; Lafleche, G. Assessing Patient Dependence in Alzheimer’s Disease. J. Gerontol. 1994, 49, 216–222. [Google Scholar] [CrossRef] [Green Version]
- Li, L.W.; Conwell, Y. Effects of Changes in Depressive Symptoms and Cognitive Functioning on Physical Disability in Home Care Elders. J. Gerontol.—Ser. Biol. Sci. Med. Sci. 2009, 64, 230–236. [Google Scholar] [CrossRef] [Green Version]
- Folstein, M.F.; Folstein, S.E.; MCHugh, P.R. “Mini-Mental State” A Practical Method for Grading the Cognitive State of Patients for the Clinician. J. Psychiatr. Res. 1975, 12, 189–198. [Google Scholar] [CrossRef] [PubMed]
- Goffman, E. Totale Instituties; van Doorn, J.A.A., van Braam, A., Leemans, E., Eds.; Universitaire Pers Rotterdam Standaard Wetenschappelijke Uitgeverij: Rotterdam, The Netherlands, 1975; ISBN go 23760247. [Google Scholar]
- van Beelen, A. Variatie Erin, Hospitalisatie Eruit. Tijdschr. Voor Verzorg. 2018, 50, 20–25. [Google Scholar] [CrossRef]
- De Medeiros, M.M.D.; Carletti, T.M.; Magno, M.B.; Maia, L.C.; Cavalcanti, Y.W.; Rodrigues-Garcia, R.C.M. Does the Institutionalization Influence Elderly’s Quality of Life? A Systematic Review and Meta-Analysis. BMC Geriatr. 2020, 20, 44. [Google Scholar] [CrossRef] [Green Version]
- Janssen, D.J.A.; Franssen, F.M.E.; Wouters, E.F.M.; Schols, J.M.G.A.; Spruit, M.A. Impaired Health Status and Care Dependency in Patients with Advanced COPD or Chronic Heart Failure. Qual. Life Res. 2011, 20, 1679–1688. [Google Scholar] [CrossRef] [Green Version]
- Van Dusseldorp, L.; Broekhuis, M.; Bruin, M.; van Egmond, S.; Fontein, J.; Gerridzen, I.; Milder, M.; Verschuur, E. COPD Zorg Voor Cliënten Met Het Syndroom van Korsakov. 2018. Available online: https://www.atlant.nl/wp-content/uploads/2021/01/PosterCOPD_TopcareSymposium_2017_DEF.pdf (accessed on 8 January 2022).
- Nakken, N.; Janssen, D.J.A.; van den Bogaart, E.H.A.; van Vliet, M.; de Vries, G.J.; Bootsma, G.P.; Gronenschild, M.H.M.; Delbressine, J.M.L.; Muris, J.W.M.; Wouters, E.F.M.; et al. Patient versus Proxy-Reported Problematic Activities of Daily Life in Patients with COPD. Respirology 2017, 22, 307–314. [Google Scholar] [CrossRef] [PubMed]
- Scheel-Hincke, L.L.; Möller, S.; Lindahl-Jacobsen, R.; Jeune, B.; Ahrenfeldt, L.J. Cross-National Comparison of Sex Differences in ADL and IADL in Europe: Findings from SHARE. Eur. J. Ageing 2020, 17, 69–79. [Google Scholar] [CrossRef] [PubMed]
- Bos, M.; Nieboer, J.; van Schouten, T.I. Empathisch Directieve Benadering Bij Cliënten Met Het Syndroom van Korsakov; Korsakov Kenniscentrum: Rotterdam, The Netherlands, 2020. [Google Scholar]
- Coninck, L. Ergotherapie in de Gerontologie; Acco België: Leuven, Belgium, 2019; ISBN 978-94-6379-269-1. [Google Scholar]
- Le Granse, M. Grondslagen van de Ergotherapie; Granse, M.L., Hartingsveldt, M., van Kinébanian, A., Eds.; Bohn Stafleu van Loghum: Berlin/Heidelberg, Germany, 2017; ISBN 978-90-368-1703-5. [Google Scholar]
Main Model | Sensitivity Analysis | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total | ADL Impaired | ADL Independent or Supervision | ADL Impaired | ADL Independent or Supervision | |||||||
Characteristic | n = 281 | (100%) | n = 72 | (26%) | n = 209 | (74%) | n = 182 | (65%) | n = 99 | (35%) | |
Age 1 | 63.2 | (SD 7.9) | 65.5 | (SD 8.1) | 62.4 | (SD 7.7) | 63.8 | (SD 7.8) | 62.1 | (SD 8.1) | |
Gender | Male | 219 | (78) | 52 | (72) | 167 | (80) | 144 | (79) | 75 | (76) |
Female | 62 | (22) | 20 | (28) | 42 | (20) | 38 | (21) | 24 | (24) | |
Length of stay in nursing home | Short (<5 years) | 138 | (49) | 27 | (38) | 111 | (53) | 81 | (45) | 57 | (58) |
Long (≥5 years) | 143 | (51) | 45 | (63) | 98 | (47) | 101 | (55) | 42 | (42) | |
Use of psycho-tropic drugs | 185 | (67) | 52 | (72) | 133 | (64) | 126 | (69) | 59 | (60) | |
Somatic disorder | Cardio-vascular diseases | 114 | (39) | 38 | (53) | 76 | (36) | 79 | (43) | 35 | (35) |
COPD | 80 | (29) | 17 | (24) | 63 | (30) | 54 | (30) | 26 | (26) | |
Neurologic diseases | 69 | (28) | 22 | (31) | 47 | (22) | 48 | (26) | 21 | (21) | |
Psychiatric disorder | Mood disorder | 85 | (31) | 22 | (31) | 63 | (30) | 56 | (31) | 29 | (29) |
Psychotic disorder | 48 | (17) | 16 | (22) | 32 | (15) | 38 | (21) | 10 | (10) | |
Personality disorder | 31 | (12) | 7 | (10) | 24 | (11) | 24 | (13) | 7 | (7) | |
Obsessive compulsive disorder a | 38 | (12) | 10 | (14) | 28 | (13) | 27 | (15) | 11 | (11) | |
CPS mean score (range 0–6) | No or mild cognitive impairment (CPS 0–1) | 89 | (32) | 8 | (11) | 81 | (39) | 38 | (18) | 51 | (52) |
Moderate cognitive impairment (CPS 2–4) | 124 | (44) | 32 | (44) | 92 | (44) | 86 | (47) | 38 | (38) | |
Severe cognitive impairment (CPS 5–6) | 68 | (24) | 32 | (44) | 36 | (17) | 58 | (32) | 10 | (10) | |
PCRS awareness discrepancy score b | No or mild impairment (score < 28) | 57 | (30) | 9 | (13) | 48 | (29) | 27 | (15) | 30 | (30) |
Moderate impairment (score 28–51) | 73 | (39) | 13 | (18) | 60 | (29) | 45 | (25) | 28 | (28) | |
Severe impairment (score > 51) | 59 | (31) | 18 | (25) | 41 | (20) | 48 | (26) | 11 | (11) | |
NPI-Q total se-verity score (o-36) 2 | 8 | (IQR 8.0) | 10 | (IQR 8.3) | 7 | (IQR 7.0) | 8.5 | (IQR 9) | 6 | (IQR 6.5) | |
NPI-Q Symptom | Irritability/lability | 192 | (68) | 53 | (74) | 139 | (67) | 126 | (69) | 66 | (67) |
Agitation/aggression | 165 | (59) | 46 | (64) | 119 | (57) | 110 | (60) | 55 | (56) | |
Apathy/indifference severity | Mild | 139 56 | (51) (20) | 44 15 | (61) (21) | 95 41 | (45) (20) | 82 38 | (45) (21) | 60 18 | (61) (18) |
Moderate | 52 | (19) | 16 | (22) | 36 | (17) | 37 | (20) | 15 | (15) | |
Severe | 31 | (12) | 13 | (18) | 18 | (9) | 25 | (14) | 6 | (6) |
Variable | Main Model | Sensitivity Analysis | |||
---|---|---|---|---|---|
β | p Value | β | p Value | ||
Age | 0.02 | 0.41 | −0.01 | 0.63 | |
Gender | Male | reference | reference | reference | reference |
Female | 1.17 | 0.02 * | −0.01 | 0.96 | |
Length of stay in nursing home | Short (<5 years) | reference | reference | reference | reference |
Long (≥5 years) | 1.13 | 0.02 * | 0.56 | 0.15 | |
Use of psychotropic drugs | −0.08 | 0.89 | 0.002 | 0.99 | |
Somatic disorder | Cardiovascular diseases | 0.01 | 0.98 | 0.22 | 0.58 |
COPD | −1.19 | 0.03 * | −0.19 | 0.66 | |
Neurologic diseases | −0.22 | 0.70 | 0.28 | 0.54 | |
Psychiatric disorder | Mood disorder | −0.52 | 0.31 | −0.60 | 0.16 |
Psychotic disorder | 0.63 | 0.24 | 0.81 | 0.11 | |
Personality disorder | −0.69 | 0.37 | 0.68 | 0.26 | |
Obsessive compulsive disorder a | −0.90 | 0.23 | −0.47 | 0.44 | |
CPS mean score (range 0–6) | No or mild cognitive impairment (CPS 0–1) | reference | reference | reference | reference |
Moderate cognitive impairment (CPS 2–4) | 0.94 | 0.11 | 1.15 | <0.01 * | |
Severe cognitive impairment (CPS 5–6) | 2.01 | <0.01 * | 1.89 | <0.01 * | |
PCRS awareness discrepancy score b | No or mild impairment (score < 28) | reference | reference | reference | reference |
Moderate impairment (score 28–51) | −0.44 | 0.45 | 0.50 | 0.24 | |
Severe impairment (score > 51) | 0.76 | 0.23 | 1.45 | <0.01 * | |
NPI-Q total severity score (o-36) | 0.06 | 0.25 | −0.03 | 0.57 | |
NPI-Q Symptom | Irritability/lability | 0.13 | 0.81 | −0.50 | 0.27 |
Agitation/aggression | 0.75 | 0.16 | 0.43 | 0.31 | |
Apathy/indifference | No apathy | reference | reference | reference | reference |
Mild | −0.32 | 0.58 | 0.70 | 0.18 | |
Moderate | −0.13 | 0.83 | 0.76 | 0.19 | |
Severe | 0.21 | 0.81 | 1.04 | 0.24 | |
Nagelkerke R2 | 32 | 32 | |||
AIC | 195.45 | 242.6 |
Characteristic | Main Model OR (95% CI) | Sensitivity Analysis OR (95% CI) | |
---|---|---|---|
Gender | Male | reference | reference |
Female | 3.23 (1.21–8.78) * | 0.99 (0.42–2.34) | |
Length of stay in nursing home | Short (<5 years) | reference | reference |
Long (≥5 years) | 3.12 (1.24–8.33) * | 1.75 (0.82–3.85) | |
COPD | 0.31 (0.01–0.84) * | 0.83 (0.37–1.89) | |
CPS | No or mild cognitive impairment (CPS 0–1) | reference | reference |
Moderate cognitive impairment (CPS 2–4) | 2.56 (0.12–8.81) | 3.16 (1.48–6.94) * | |
Severe cognitive impairment (CPS 5–6) | 7.46 (2.10–30.5) * | 6.64 (2.20–23.23) * | |
PCRS discrepancy score a | No or mild impairment (score < 28) | reference | reference |
Moderate impairment (score 28–51) | 0.65 (0.49–2.04) | 1.65 (0.72–3.83) | |
Severe impairment (score > 51) | 0.75 (0.16–7.50) | 4.25, (1.56–12.32) * |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Böhner, E.S.; Spek, B.; Joling, K.J.; Zwaagstra, Y.; Gerridzen, I.J. Factors Associated with ADL Dependence in Nursing Home Residents with Korsakoff’s Syndrome and Other Alcohol-Related Disorders: An Explorative Cross-Sectional Study. J. Clin. Med. 2023, 12, 2181. https://doi.org/10.3390/jcm12062181
Böhner ES, Spek B, Joling KJ, Zwaagstra Y, Gerridzen IJ. Factors Associated with ADL Dependence in Nursing Home Residents with Korsakoff’s Syndrome and Other Alcohol-Related Disorders: An Explorative Cross-Sectional Study. Journal of Clinical Medicine. 2023; 12(6):2181. https://doi.org/10.3390/jcm12062181
Chicago/Turabian StyleBöhner, Eline S., Bea Spek, Karlijn J. Joling, Yvonne Zwaagstra, and Ineke J. Gerridzen. 2023. "Factors Associated with ADL Dependence in Nursing Home Residents with Korsakoff’s Syndrome and Other Alcohol-Related Disorders: An Explorative Cross-Sectional Study" Journal of Clinical Medicine 12, no. 6: 2181. https://doi.org/10.3390/jcm12062181
APA StyleBöhner, E. S., Spek, B., Joling, K. J., Zwaagstra, Y., & Gerridzen, I. J. (2023). Factors Associated with ADL Dependence in Nursing Home Residents with Korsakoff’s Syndrome and Other Alcohol-Related Disorders: An Explorative Cross-Sectional Study. Journal of Clinical Medicine, 12(6), 2181. https://doi.org/10.3390/jcm12062181