Table 3.
Clinically Significant Symptoms and 5-year Risk of Institutionalization
| Clinically Significant Symptoms† | |||
|---|---|---|---|
| HR* (95% CI) | |||
| NPI Symptom(s) | Base Model | Adjusted for Caregiver Distress | Adjusted for Functional Limitations |
| 0 | Reference | Reference | Reference |
| ≥1 | 2.36 (0.87-6.42) | 2.77 (0.36-21.36) | 2.30 (0.86-6.18) |
| Cognitive Category | 1.77 (1.27-2.47) | 1.78 (1.27-2.50) | 1.67 (1.08-2.57) |
| Caregiver Distress | - | 0.90 (0.40-2.01) | - |
| ADL Limitations | - | - | 0.75 (0.43-1.30) |
| IADL Limitations | - | - | 1.21 (0.79-1.85) |
| Delusions | 5.74 (1.94-16.96) | 3.87 (0.96-15.58) | 7.13 (2.67-19.02) |
| Hallucinations | 0.14 (0.01-2.68) | 0.25 (0.00-8.75) | 0.18 (0.01-4.36) |
| Agitation | 4.70 (1.07-20.70) | 3.41 (0.85-13.58) | 5.77 (1.00-33.51) |
| Depression | 2.09 (0.30-14.47) | 1.41 (0.11-17.15) | 1.44 (0.10-19.42) |
| Apathy | 0.24 (0.08-0.74) | 0.15 (0.04-0.60) | 0.22 (0.08-0.63) |
| Elation‡ | - | - | - |
| Anxiety | 0.32 (0.04-2.33) | 0.21 (0.02-1.56) | 0.24 (0.03-1.95) |
| Disinhibition | 0.08 (0.00-1.40) | 0.06 (0.00-0.74) | 0.22 (0.02-1.91) |
| Irritation | 0.52 (0.16-1.66) | 0.35 (0.08-1.39) | 0.49 (0.11-2.03) |
| Aberrant Motor Behaviors | 2.99 (0.47-19.01) | 2.37 (0.34-16.17) | 3.29 (0.44-24.18) |
| Cognitive Category | 1.93 (1.27-2.93) | 1.89 (1.27-2.81) | 1.83 (1.13-2.98) |
| Caregiver Distress | - | 1.67 (0.71-3.95) | - |
| ADL Limitations | - | - | 0.94 (0.43-2.02) |
| IADL Limitations | - | - | 1.03 (0.60-1.76) |
*
HR derived by using a Cox proportional hazards regression model with the 5-year risk of institutionalization as the dependent variable. 95% confidence intervals are in parentheses. The model adjusts for cognitive category (e.g., CIND, mild/moderate/severe dementia), sociodemographic characteristics, and long-term care insurance.
†
Clinically significant symptoms is defined as a frequency score times severity score of >=4.
‡
Unable to estimate due to small sample size
Abbreviation: NPI, Neuropsychiatric Inventory. ADL, activity of daily living. IADL, instrumental activity of daily living