Dementia in United States nursing homes: descriptive epidemiology and implications for long-term residential care

Using data from the 1985 National Nursing Home Survey, the health and functioning of demented and non-demented nursing home residents are compared, and alternate forms of long-term residential care are identified. The 1985 National Nursing Home Survey is a cross-sectional investigation of residents in 1079 nursing and related care homes in the United States. Subjects for comparative analyses include 4622 residents age 65 and older from these facilities. Fifty-one percent had a diagnosis of dementia. Compared with non-demented residents, those with dementia had more impairments in physical and instrumental tasks of daily living, behavioral problems, and psychiatric symptoms, and fewer physical health comorbidities. Although statistically significant, many of the differences were small. Analyses indicate that there is considerable overlap in the health and functional status of nursing home residents with and without dementia. Both groups are heterogeneous in health and functioning and both have members without impairments. The traditional nursing home is one option for providing long-term residential care for these persons. Alternate residential care facilities such as board and care homes, sheltered housing and adult foster care are other options whose use is growing, especially for those not requiring continuous supervision and medical care.