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Wandering Behavior and SARS-CoV-2 Infection in Veterans Affairs Community Living Center Residents.
Singh, Mriganka; DeVone, Frank; Bayer, Thomas; Abul, Yasin; Garbin, Alexander; Leeder, Ciera; Halladay, Chris; McConeghy, Kevin W; Gravenstein, Stefan; Rudolph, James L.
Afiliación
  • Singh M; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA. Electronic address: mriganka_singh@brown.edu.
  • DeVone F; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA.
  • Bayer T; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA.
  • Abul Y; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA.
  • Garbin A; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO, USA; Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.
  • Leeder C; Clifton Springs Hospital, Department of Medicine and Geriatrics, Clifton Springs, NY, USA.
  • Halladay C; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA.
  • McConeghy KW; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA.
  • Gravenstein S; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA; Department of Health Services, Policy, and Practice, Brown University School of Publi
  • Rudolph JL; Center of Innovation in Long Term Services and Supports (LTSS-COIN), Providence VA Medical Center, Providence, RI, USA; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO, USA; Department of Health Services, Policy, and
J Am Med Dir Assoc ; 25(8): 105101, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38906176
ABSTRACT

OBJECTIVE:

Wandering behavior in nursing home (NH) residents could increase risk of infection. The objective of this study was to assess the association of wandering behavior with SARS-CoV-2 infection in Veterans Affairs (VA) Community Living Center (CLC) residents.

DESIGN:

Retrospective cohort study. SETTING &

PARTICIPANTS:

Veterans residing in 133 VA CLCs.

METHODS:

We included residents with SARS-CoV-2 test from March 1, 2020 to December 31, 2020 from VA electronic medical records. We identified CLC residents with wandering on Minimum Data Set 3.0 assessments and compared them with residents without wandering. The outcome was SARS-CoV-2 infection, as tested for surveillance testing, in those with and without wandering. Generalized linear model with Poisson link adjusted for relevant covariates was used.

RESULTS:

Residents (n = 9995) were included in the analytic cohort mean, (SD) age 73.4 (10.7); 388 (3.9%) women. The mean (SD) activities of daily living score in the overall cohort was 13.6 (8.25). Wandering was noted in 379 (3.8%) (n = 379) of the cohort. The exposure groups differed in prior dementia (92.6% vs 62.1%, standardized mean difference [SMD] = 0.8) and psychoses (41.4% vs 28.1%, SMD = 0.3). Overall, 12.5% (n = 1248) tested positive for SARS-CoV-2 and more residents among the wandering group were SARS-CoV-2 positive as compared with those in the group without wandering (19% [n = 72] vs 12.2% [n = 1176], SMD = 0.19). Adjusting for covariates, residents with wandering had 34% higher relative risk for SARS-CoV-2 infection (adjusted relative risk, 1.34; 95% CI, 1.04-1.69). CONCLUSIONS AND IMPLICATIONS CLC residents with wandering had a higher risk of SARS-CoV-2 infection. This may inform implementation of infection control and isolation policies as NHs attempt to balance ethical concepts of resident autonomy, proportionality, equity, and utilitarianism.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Veteranos / Conducta Errante / COVID-19 Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Am Med Dir Assoc Asunto de la revista: HISTORIA DA MEDICINA / MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Veteranos / Conducta Errante / COVID-19 Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Am Med Dir Assoc Asunto de la revista: HISTORIA DA MEDICINA / MEDICINA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos