Predicting functional decline of older men living in veteran homes by minimum data set: implications for disability prevention programs in long term care settings.

OBJECTIVE

To evaluate the risk and protective factors for functional decline of veteran home residents in Taiwan to develop disability prevention programs in long term care settings.

DESIGN

A prospective cohort study.

SETTING

Two veteran homes in Taiwan.

PARTICIPANTS

A total of 1045 residents of veteran homes.

INTERVENTION: None.

MEASUREMENTS: Minimum data set (MDS), resident assessment protocols (RAP), MDS-COGS, Resource Utilization Group-III Activities of Daily Living scale, MDS Social engagement scale, MDS Pain scale.

RESULTS

A total of 1045 (83.0 ± 5.1 years, all men) residents completed the study, and 11.3% of them developed significant functional decline during the study period. Participants with long-term institutionalization history (odds ratio [OR] 2.966, confidence interval [CI] 1.270-6.927), underlying cerebrovascular disease (OR 4.432, CI 1.994-9.852) and dementia (OR 2.150, CI 1.029-4.504), and higher sum of RAP triggers (OR 1.366, CI 1.230-1.517) were more likely to develop functional decline, whereas those who had better social engagement were significantly protective from functional decline (OR 0.528, CI 0.399-0.697).

CONCLUSIONS

Cerebrovascular disease, dementia, higher sum of RAP triggers, and long-term institutionalization were independent risk factors for functional decline, whereas better social engagement had a protective effect on functional dependence. Further study is needed to develop an integrated disability prevention program based on the discoveries of this study.