Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;18(10):1880-1888.
doi: 10.1002/alz.12513. Epub 2022 Jan 3.

Memory care reduces nursing home admissions among assisted-living residents with dementia

Portia Y Cornell  1 , Wenhan Zhang  1 , Lindsey Smith  2 , Momotazur Rahman  1 , David C Grabowski  3 , Paula Carder  2 , Kali S Thomas  4   1
Affiliations

Memory care reduces nursing home admissions among assisted-living residents with dementia

Portia Y Cornell et al. Alzheimers Dement. 2022 Oct.

Abstract

Introduction: We compare nursing-home and hospital admissions among residents with Alzheimer's disease and related dementias (ADRD) in memory-care assisted living to those in general assisted living.

Methods: Retrospective study of Medicare beneficiaries with ADRD in large (>25 bed) assisted-living communities. We compared admission to a hospital, to a nursing home, and long-term (>90 day) admission to a nursing home between the two groups, using risk differences and survival analysis.

Results: Residents in memory-care assisted living had a lower adjusted risk of hospitalization (risk difference = -1.8 percentage points [P = .014], hazard ratio = 0.93 [0.87-1.00]), a lower risk of nursing-home admission (risk difference = -2.2 percentage points [P < .001], hazard ratio = 0.87 [-.79-0.95]), and a lower risk of a long-term nursing home admission (risk difference = -1.1 percentage points [P < .001], hazard ratio = 0.71 [0.57-0.88]).

Discussion: Memory care is associated with reduced rates of nursing-home placement, particularly long-term stays, compared to general assisted living.

Keywords: Alzheimer's disease and related dementias; assisted living; dementia care; hospitalization; memory care; nursing home admission; residential care.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no financial conflicts of interest to report.

Figures

FIGURE 1
FIGURE 1
Stratified outcomes by propensity score. Notes: Risk of outcomes for memory care and general assisted living are shown by quintile of the propensity score. Propensity score calculated using resident demographics, chronic conditions, previous health care use, and characteristics of patients’ previous home county (see Table 1)
FIGURE 2
FIGURE 2
FI Kaplan-Meier estimates of the probability of outcomes. Notes: Kaplan-Meier hazard curves are shown using inverse-propensity treatment weights. Hazard ratios for outcomes are calculated using Cox proportional hazards regressions. Additional detail can be found in the technical appendix
See this image and copyright information in PMC

References

    1. Harris-Kojetin LD, Sengupta M, Lendon JP, Rome V, Valverde R, Caffrey C. Long-term care providers and services users in the United States, 2015–2016. Vital Health Stat. 2019;3(43). Feb. DHHS Publication No. 2019–1427, p. 18, Fig. 19. - PubMed
    1. Thomas KS, Zhang W, Cornell PY, Smith L, Kaskie B, Carder PC. State variability in the prevalence and healthcare utilization of assisted living residents with dementia. J Am Geriatr Soc. 2020;68(7):1504–1511. Jul. - PMC - PubMed
    1. Zimmerman S, Sloane PD, Reed D. Dementia prevalence and care in assisted living. Health Aff. 2014;33(4):658–666. Apr 1. - PubMed
    1. Carder PC. State regulatory approaches for dementia care in residential care and assisted living. Gerontologist. 2017;57(4):776–786. - PubMed
    1. Kaskie BP, Nattinger M, Potter A. Policies to protect persons with dementia in assisted living: déjà vu all over again. Gerontologist. 2015;55(2):199–209. Apr 1. - PMC - PubMed

Publication types