Physical Restraint and Antipsychotic Medication Use among Nursing Home Residents with Dementia

PURPOSE:

To explore antipsychotic (AP) medications and physical restraint use and their effects on physical function and cognition in older nursing home residents.

METHODS:

This retrospective cohort studied involved 532 residents with dementia from 57 nursing homes participating in the Services and Health for Elderly in Long-Term Care study. Poisson log regression models explored the effect of physical restraint and/or AP medication use on cognitive or functional decline at 6 months.

RESULTS:

Physical restraint use was associated with a higher risk of both functional and cognitive decline compared with AP medication use alone. These risks were highest among residents receiving both AP medications and physical restraints, suggesting additive effects.

DISCUSSION:

Physical restraint use, and even more strongly, concurrent physical restraint and AP medication use, is related to function and cognitive decline in nursing home residents with dementia. Antipsychotic use is cautioned, but these results suggest physical restraint use is potentially more risky.

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By:  Foebel AD1, Onder G2, Finne-Soveri H3, Lukas A4, Denkinger MD4, Carfi A2, Vetrano DL2, Brandi V2, Bernabei R2, Liperoti R2.

• 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: andrea.foebel@ki.se.
• 2Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.
• 3Aging and Services Unit, National Institute for Health and Welfare, Helsinki, Finland.
• 4AGAPLESION Bethesda Clinic, Geriatric Center, Ulm University, Ulm, Germany.
• J Am Med Dir Assoc. 2016 Jan 5. pii: S1525-8610(15)00725-2. doi: 10.1016/j.jamda.2015.11.014.  

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