161 - Cognition of Skilled Nursing Facility (SNF) Residents Status, Progression, Diagnosis, and Treatment: Current Findings from Analysis of US National SNF Records

Friday, February 23, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

HS

Hammad Sadiq, BS

Medical Student
University of New England College of Osteopathic Medicine
Saco, Maine, United States
HS

Hafsa Sadiq, BA

Medical Student
University of New England College of Osteopathic Medicine
Saco, Maine, United States

Corresponding Author(s)

RS

Richard Stefanacci, DO, MGH, MBA, AGSF, CMD

Adjunct Assistant Professor
Jefferson College of Population Health, Thomas Jefferson University
Philadelphia, Pennsylvania, United States

Co-Author(s)

AS

Allana Skura, BSc

Director, Life Sciences
PointClickCare
Wilmot, Ontario, Canada
BW

Brittin Wagner, PhD

Senior Research Scientist
PointClickCare
-, Ontario, Canada
HB

Heming Bai, BSc

Senior Data Analyst
PointClickCare
Toronto, Ontario, Canada
AN

Aaron Norfolk, BSc

Director, Life Sciences
PointClickCare
-, British Columbia, Canada

Objectives: Address knowledge gaps and provide a comprehensive overview on ADRD management, cognition status, and changes in cognition over the course of patients’ stays in these facilities utilizing data by PointClickCare.

Design: Our study investigates the dynamic landscape of ADRD within the United States SNFs, offering an up-to-date view of dementia prevalence, management, and cognition status changes among residents. Leveraging nationwide data from PointClickCare, we analyze the demographic and clinical characteristics of patients admitted and discharged from SNFs during Q1 2023.

Results: On admission, 41.3% of SNF residents were identified as cognitively intact, while approximately half were evenly distributed between moderate and severe cognitive impairment (26.8% and 26.2%, respectively), and with only 5.7% having very severe cognitive impairment. Among 57, 331 admissions, ADRD diagnosis rates were notably low at 26%, in contrast to the 34.8% that were identified as having either moderate, severe, or very severe cognitive impairment. Among discharged patients (N=49,391), cognitively intact patients had shorter mean lengths of stay (LOS) than severely impaired patients (588 vs. 677 days). Similar trends were observed among terminal stay patients (N=23,897), where greater cognitive impairment resulted in longer LOS. Cognitive status remained stable in 55.1% of discharged patients, while 12.6% improved, and 32.2% declined. This means that a third of the SNF residents had a cognitive decline during their admission.

Conclusions: This study highlights that a significant portion of the population of skilled nursing facility residents are cognitively intact while possible opportunities exist to improve ADRD screening, diagnosis, and treatment in SNFs to address the diverse needs of this vulnerable population as the aging population in the U.S. continues to grow.