Six-Month Cognitive Improvement in Nursing Home Residents With Severe Cognitive Impairment

The number of patients in nursing homes with severe cognitive impairment (SCI) is growing. The authors compared the characteristics and 6-month outcomes of a sample of nursing home residents with SCI to those of other residents. This cross-sectional and 6-month follow-up study used data from pooled 1990 and 1993 cohorts in the Resident Assessment Instrument Evaluation Study. The authors compared baseline characteristics of residents with SCI (n = 1304) with all others and evaluated 6-month improvement and associated factors in the SCI group. SCI residents had poorer nutrition and lower frequencies of most symptoms and chronic diseases. Fourteen percent showed 6-month cognitive improvement, associated with higher baseline function, antidepressant medication, and recent falls. Nursing home residents with SCI had possible underrecognition of medical problems and poor nutritional status. Measured improvement may indicate possible misclassification for some residents and potential for improvement for others.