Abstract

Background: Cognitive impairment and dementia are predictors of institutionalization in the elderly. Moreover, the level of cognitive impairment and institutionalization are directly related to affective problems. The purpose of this longitudinal study was to assess and compare the short-term evolution of cognitive and affective status of day-care and nursing home patients at 1-year follow-up, and the presence of cognitive and affective disorders as a function of the type of care services. Methods: A total of ninety-four institutionalized older adults aged ≥65 years from a gerontological centre located in A Coruña (Spain), (56 day-care patients and 38 nursing home residents) was available at baseline, and sixty-three (40 day-care patients and 23 institutionalized patients) were reassessed at 1-year follow-up. Neuropsychological assessment included measures of cognitive function (Mini-Mental State Examination, Reisberg’s Global Deterioration Scale, and Alzheimer’s Disease Assessment Scale–cognitive subscale), Visuospatial skills (Trail Mak¬ing Test-A), language abilities (Verbal Fluency Test), and affective status assessment (Geriatric Depression Scale - Short Form). The day-care recipients and nursing home residents’ characteristics were compared at baseline and follow-up by means of the Student’s t-test for independent samples. In addition, the Student’s paired t-test was used to compare the cognitive and affective scores between the two assessments points for each group. Results: Spatial orientation, short-term memory and written language were the most affected cognitive functions regardless of the care setting. Our findings revealed a similar global cognitive decline rate after 1-year follow-up in both groups, and slightly and minimally clinically important different trajectories in other outcomes, such as naming function and presence of depressive symptoms. Conclusion: Based on the results from our study, the elderly people who attend a day care centre or reside in a nursing home are more prone to have cognitive impairment and depressive symptoms over time. Further longitudinal studies are needed to confirm it.

This work was supported by the Xunta de Galicia (FrailNet network IN607C 2016/08 and ED431C 2017/49).