Characteristics of older adults with moderately severe dementia differ depending on care settings

Reviewed by James Ives, M.Psych. (Editor)Aug 7 2019

A study published in the Journal of the American Geriatrics Society has found that many characteristics among older adults with moderately severe dementia differ depending on whether they live at home or in residential care or nursing facilities.

The study used a nationally-representative dataset of U.S. older adults and included 728 people newly identified as having moderately severe dementia between 2012 and 2016. Sixty four percent received care at home, 19% in residential care, and 17% in a nursing facility.

Individuals living at home were two to five times more likely to be members of disadvantaged populations (such as being a racial/ethnic minority, not being born in the United States, and having less than a high school education). Those living at home also had worse health and more symptoms than those living in residential care or nursing facilities.

When researchers extrapolated their results, they estimated that 3.3 million older U.S. adults developed moderately severe dementia between 2012 and 2016.

In our experience, many people live at home with dementia even when things get hard, yet we know virtually nothing about this population. Prior research focused on people with advanced dementia in nursing homes. Our study is one of the first to describe people living at home at a stage of dementia plus moderate functional impairment and to compare this population to people with dementia in other settings in the United States. This is a key step towards better understanding and addressing the geriatric palliative care needs of people with dementia wherever they live."

Lead author Krista L. Harrison, PhD, University of California San Francisco