Table 3.
Adjusted odds ratios (95% confidence intervals) for antipsychotic use associated with resident characteristics (DAL and LTC)
| Resident characteristic | Odds ratio (95% confidence interval) | |
|---|---|---|
| DAL (n = 1089)a | LTC (n = 1000)b | |
| Sociodemographic | ||
| Age, years | ||
| 65–79 (ref gp) | 1.00 | 1.00 |
| 80–85 | 0.72 (0.49–1.06)** | 0.65 (0.43–1.00)* |
| 86–89 | 0.67 (0.42–1.06)** | 0.57 (0.34–0.96)* |
| ≥90 | 0.64 (0.40–1.01)** | 0.60 (0.38–0.96)* |
| Sex | ||
| Male | 1.15 (0.80–1.65) | 1.22 (0.87–1.72) |
| Facility length of stay, months | ||
| <12 (ref gp) | 1.00 | |
| 12–24 | 1.36 (0.95–1.96)** | |
| >24 | 1.66 (1.17–2.35)* | |
| Health and functional status | ||
| Dementia and treatment status | ||
| No dementia (ref gp) | 1.00 | 1.00 |
| Dementia, not treated | 2.73 (1.98–3.74)* | 1.97 (1.37–2.84)* |
| Dementia, treated | 2.45 (1.55–3.86)* | 3.09 (1.91–5.00)* |
| Psychiatric diagnoses | 2.06 (1.27–3.33)* | 2.14 (1.48–3.11)* |
| Delusions/hallucinations | 1.76 (0.99–3.14)** | 2.01 (1.35–3.00)* |
| Cardiovascular disease | 0.73 (0.54–1.00)* | |
| Cerebrovascular disease | 0.55 (0.34–0.89)* | |
| Antidepressants | 1.99 (1.43–2.75)* | 2.18 (1.56–3.05)* |
| Anxiolytics | 1.82 (1.17–2.81)* | |
| Sedatives/hypnotics | 1.56 (1.06–2.28)* | |
| FI | ||
| Robust (FI score <0.2) (ref gp) | 1.00 | |
| Pre-frail (FI score 0.2–0.3) | 1.18 (0.79–1.74) | |
| Frail (FI score >0.3) | 1.92 (1.29–2.86)* | |
| FI (binary)c | ||
| Robust/pre-frail (FI score ≤0.3) | 1.00 | |
| Frail (FI score >0.3) | 1.82 (1.15–2.87)* | |
| Physical restraints | 1.35 (0.97–1.89)** | |
| Behavioral characteristics | ||
| Aggressive behavior (ABS score) | ||
| None (0) (ref gp) | 1.00 | 1.00 |
| Moderate (1–2) | 1.41 (0.86–2.30) | 1.53 (1.00–2.35)** |
| Severe to very severe (≥3) | 2.12 (1.37–3.29)* | 2.05 (1.36–3.09)* |
| Elopement attempts or threatsd | 1.63 (1.05–2.54)* | 1.68 (1.07–2.62)* |
| Wanderingd | 1.48 (0.99–2.23)** | |
ABS Aggressive Behavior Scale, AL assisted living, DAL designated assisted living, FI Frailty Index, LTC long-term care, ref gp reference group
aThe full multivariable logistic model for DAL adjusts for: age, sex, dementia/treatment status, psychiatric diagnoses, presence of delusions/hallucinations, frailty status, cardiovascular diagnoses, cerebrovascular diagnoses, AL length of stay, ABS score, elopement attempts or threats, and use of antidepressant medication
bThe full multivariable logistic model for LTC adjusts for: age, sex, dementia/treatment status, psychiatric diagnoses, presence of delusions/hallucinations, frailty status, ABS score, elopement attempts or threats, wandering, use of physical restraints, and use of antidepressant, anxiolytic, and sedative/hypnotic medications
cBecause of the small sample of LTC residents found to be robust by the FI, a binary variable was used for LTC analyses (robust/pre-frail residents combined for comparison with frail residents)
dBecause of collinearity, the variables elopement attempts/threats and wandering could not be retained together in the fully-adjusted model for DAL. Elopement attempts/threats was retained in the model on the basis of its p-value (p = 0.030) compared with wandering (p = 0.044) when included separately in the full model
* p < 0.05; ** p < 0.1