Prevalence of cognitive impairment among long-term care residents: a comparison between nursing homes and residential homes in Poland

Abstract

Purpose: Large-scale nationwide comparative studies of older adults with cognitive impairment (CI) in long-term care institutions (LTCI) hardly exist in Poland. This paper compares the prevalence of CI and its symptoms in residents of nursing homes (NHs) and residential homes (RHs) in Poland. Methods: A cross-sectional survey of a country-representative sample of 23 LTCIs was conducted in the years 2015–2016. In total, 1587 residents were included: 626 residents in 11 NHs and 961 residents in 12 RHs. All individuals were assessed with a Cognitive Performance Scale (CPS) using a cutoff of ≥ 2 points to define the presence of CI. Descriptive statistics and Chi square test were used. Results: The median age was 80 years, 67.7% were women. Overall, 65.2% of residents (n = 1035) were identified as having CI, ranging from 59.2% in RHs to 74.5% in NHs, after excluding residents in a coma. Furthermore, the prevalence of severe CI was significantly higher in NHs than in RHs (respectively, 41.2 and 20.5%). It concerned specifically impairment of memory: procedural (72.3 vs 55.2%), long-term (56.5 vs 32.1%), short-term (46.8 vs 33.4%), and situational one (40.2 vs 26.4%), as well as problems with being understood by others (44.6 vs 24.7%) and severely impaired capacity of daily decision making (44.7 vs 21.5%). Conclusions: A high prevalence of CI was found in both LTCI types, but its severity differed, with statistically significantly higher rates in NHs compared to RHs. Therefore, we call for more attention to be paid to better recognition of CI in LTCI residents, regardless of the facility type.