Physical Restraint and Antipsychotic Medication Use Among Nursing Home Residents With Dementia

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• 作者：Andrea D. Foebel ; PhD^a ; ^b ; ^{andrea.foebel@ki.se" class="auth_mail" title="E-mail the corresponding author} ; Graziano Onder ; MD ; PhD^b ; Harriet Finne-Soveri ; MD ; PhD^c ; Albert Lukas ; MD^d ; Michael D. Denkinger ; MD ; PhD^d ; Angelo Carfi ; MD^b ; Davide L. Vetrano ; MD^b ; Vincenzo Brandi ; MD^b ; Roberto Bernabei ; MD^b ; Rosa Liperoti ; MD ; MPH ; PhD^b
• 关键词：Physical restraint ; antipsychotics ; dementia ; nursing homes ; cognition ; activities of daily living
• 刊名：Journal of the American Medical Directors Association
• 出版年：2016
• 出版时间：1 February 2016
• 年：2016
• 卷：17
• 期：2
• 页码：184.e9-184.e14
• 全文大小：348 K

文摘

To explore antipsychotic (AP) medications and physical restraint use and their effects on physical function and cognition in older nursing home residents.

Methods

This retrospective cohort studied involved 532 residents with dementia from 57 nursing homes participating in the Services and Health for Elderly in Long-Term Care study. Poisson log regression models explored the effect of physical restraint and/or AP medication use on cognitive or functional decline at 6 months.

Results

Physical restraint use was associated with a higher risk of both functional and cognitive decline compared with AP medication use alone. These risks were highest among residents receiving both AP medications and physical restraints, suggesting additive effects.

Discussion

Physical restraint use, and even more strongly, concurrent physical restraint and AP medication use, is related to function and cognitive decline in nursing home residents with dementia. Antipsychotic use is cautioned, but these results suggest physical restraint use is potentially more risky.