Summaries of Studies on Health and Aging for Your Patients

Residents of long-term care (LTC) facilities and their families often have questions about practices and policies in LTC settings. They may ask, for example, why medical staff recommend some, but not other, treatments for problems such as sleeplessness; why a particular exercise regimen has been recommended; or why a hospitalization should be followed by a stay at a rehabilitation center rather than immediate return to LTC. These are good questions, and they deserve thoughtful answers. The more residents and their loved ones understand the rationales behind protocols and suggestions, the more likely they are to comply with them.

When explaining such matters, it’s often helpful to refer patients and their families to information on the subject at hand. Unfortunately, not all of the health information available on the Internet or television or in magazines or newspapers is reliable. To help address this, the American Geriatrics Society’s (AGS) Foundation for Health in Aging (FHA) publishes easy-to-understand summaries of studies on health and aging in the Journal of the American Geriatrics Society (JAGS). A good number of these summaries are of studies concerning LTC. The reports, posted in the “New Research” section of the FHA’s “Aging in the Know” website, have been reviewed and approved by the studies’ authors. Each provides background information, describes the JAGS research, and includes links to related information on the FHA site. The summaries can be printed and distributed to residents and their loved ones at no cost.

Here are a few brief synopses of recent reports of JAGS studies relevant to LTC from the “Aging in the Know” site:

After Stroke, Many Older Adults Face Complicated Transitions

Older adults who have had strokes often face many transitions after they leave the hospital. After returning home or to a LTC facility, some may develop medical complications and have to return to the hospital or to an emergency room.

Healthcare providers call transitions from a setting that provides less intense care (eg, someone's home or a LTC facility) to a setting that provides more intense care (eg, hospital) "complicated transitions." To better understand which older individuals are most likely to have complicated transitions, researchers recently studied nearly 40,000 older adults who were hospitalized after having strokes. About 20% of the patients had at least one complicated transition, and 16% had more than one, the researchers found.

Older patients who: were African-American; were Medicaid beneficiaries; had longer hospital stays; had more health problems; or were sent to a LTC facility directly from the hospital were more likely to have at least one complicated transition than other patients. Because patients who were sent from hospitals to rehabilitation centers before going back home or back to a LTC facility were less likely to have complicated transitions, an intermediate stay at a rehabilitation center after hospitalization may lower the odds of a difficult transition, the researchers conclude. (For the full summary of this study, visit healthinaging.org/agingintheknow/research_content.asp?id=97 )

Exercise Can Help Nursing Home Residents with Alzheimer's Disease Manage Activities of Daily Living Longer

Alzheimer's disease (AD) makes it increasingly difficult to think, remember and manage daily activities such as eating, transferring from bed to chair, walking, bathing, dressing and going to the toilet.

To see whether regular exercise might help nursing home residents with AD manage these activities longer, researchers studied 134 older people. All lived in nursing homes and had AD.

For 12 months, half of the adults participated in a twice-weekly exercise program. The other adults did not. Even though all of the adults in the study were less able to manage daily activities at the end of the year than at the beginning, the researchers found that those in the exercise group had smaller losses in these abilities than those who didn't exercise. This research suggests that regular exercise may help older adults with AD maintain their ability to manage daily activities. (For the full summary, visit healthinaging.org/agingintheknow/research_content.asp?id=91)

Some Sleep Problems Among Nursing Home Residents Can Be Helped Without Medications

Sleep problems are common among nursing home residents. Many older residents wake up often during the night and doze often during the day. Sleep medications such as sedatives, however, may not be helpful for older adults. These drugs may boost risks of falling.

To find out whether non-drug remedies for sleep problems might be effective in nursing homes, researchers recently studied residents with sleep problems at four nursing homes. Some of the residents were assigned to an “intervention” group; the others were not. Nursing home staff encouraged residents in the intervention group to stay out of bed between 8:00 AM and 8:00 PM, and to get at least 30 minutes of sunlight and gentle exercise during that time. Between 8:00 and 10:00 PM, staff turned out lights in the residents’ rooms, kept lighting low in hallways, and made efforts to keep noise levels down. Later in the evening, staff tried to limit certain types of care—turning residents, for example—to times when residents were awake, instead of waking them to provide such care.

Residents in the intervention group appeared to get a better night’s sleep as a result. They slept less during the day, and participated more in daily activities and conversations than those who weren’t in the intervention group, the researchers report. (For the full summary, visit healthinaging.org/agingintheknow/research_content.asp?id=15)

Multivitamin and Mineral Supplements Lower Risks of Infection Among Older Nursing Home Residents Without Dementia

For a variety of reasons, many older adults living in nursing homes don't get all the vitamins and minerals they need from food. Some older residents have health problems or take medications that have side effects that make it harder to eat a variety of foods and get needed nutrients such as vitamins and minerals.

We know that this can cause problems because vitamins and minerals play important roles in the body. Not getting enough vitamins and minerals can lower immunity—the body's ability to fight infections, among other things.

To find out whether giving multiple vitamin and mineral pills to nursing home residents might boost their immunity and help protect them from infections, researchers studied 750 adults living in nursing homes. For 19 months, about half of the residents were given a multiple vitamin and mineral pill. The other half got a placebo or "sugar pill."

Overall, the adults who were given the multiple vitamin and mineral pills had just as many infections as the adults who received the sugar pills, the researchers found. Among adults who didn't have dementia, however, those receiving the multiple vitamin and mineral pills had fewer infections than those given the sugar pills. Because supplements can have other helpful effects, aside from preventing infections, it may be worthwhile to give them to both older adults who don’t have dementia and those who do, the researchers write. (For the full summary, visit healthinaging.org/agingintheknow/research.asp)