Grants and Funded Projects

Anxiety Among Older Adults with Dementia in ALFs
(National Institute of Nursing Research – F31 NR009445)
Principal Investigator: Marianne Smith, MS, RN

The purpose of this study is to characterize anxiety symptoms among older adults with dementia who are living in assisted living facilities (ALFs). Assisted living is rapidly becoming an important part of the health care continuum, but remains largely unstudied in nursing and interdisciplinary search. Results of the Maryland Assisted Living (MD-AL) Study conducted at Johns Hopkins University indicate mental disorders are prevalent in assisted living: 67.7% of had dementia, 10% had other cognitive impairments and 26.3% had non-cognitive psychiatric illness. Little is known about dementia in ALFS, and even less is known about anxiety symptoms. Four aims of this descriptive correlational study are to 1) determine the prevalence of anxiety symptoms and comorbid anxiety and depression among older adults with dementia living in ALFs; 2) determine the relationship between anxiety and other clinical, demographic, and facility-related variables among those with dementia; 3) determine the relationship between anxiety and other variables among those without dementia; and 4) identify variables that predict anxiety among older adults with dementia living in ALFs. Research with community-dwelling older adults indicates that anxiety symptoms are common, affecting as many as 70% of those with dementia. Anxiety symptoms in dementia create distress and discomfort and are associated comorbid depression, greater functional impairment, behavioral symptoms, reduced quality of life, and increased mortality. Limited research about dementia in ALFs indicates that behavioral symptoms are common, and are a common reason for discharge to a higher level of care. Given that anxiety symptoms often arise in response to confusing or uncomfortable aspects of the environment and escalate into more dysfunctional and combative behaviors, description of anxiety in ALFs is needed to later develop and test ALF-specific nursing interventions. Data from the MD-AL study (n=198) will be analyzed using descriptive and nonparametic statistics and logistic regression to describe anxiety and its relationship to cognitive impairment, depression, functional status, agitation, disinhibition, irritability, aberrant motor behavior, psychotropic medication use, and resident and facility characteristics.