Background Many persons living with dementias (PLWD) prefer to remain at home as long as possible, and days spent at home (DAH)—defined as the time an individual spends outside of healthcare facilities—has emerged as a person-centred outcome measure in this population. We examined the association between DAH and functional status and health among PLWD. Methods Utilizing a nationally representative cohort of individuals age 65 and older in the United States with dementia from the 2010–2018 Health and Retirement Study (HRS), we assessed the relationship between an ordinal categorical DAH variable and number of activities of daily living (ADLs) (range 0–10; 10 being independent), mobility (0–5; 5 being mobile), and self-rated health (SRH) (0–4; 4 being excellent), controlling for patient characteristics. DAH was defined as the number of self-reported days spent outside a hospital or nursing home in the time between survey waves, typically 730 days. Results We identified 3002 participants (4192 observations, average 1.4 observations per participant). The mean DAH was 704.4 days (SD 10.8 days) and 64.9% spent all days at home (i.e. 730 days). A 2-week decrease in DAH was associated with a lower ADL score by 0.32 points (95% confidence internal [CI]: 0.24–0.40, P-for-trend<0.001), a lower mobility score by 0.18 points (95% CI: 0.13–0.22, P-for-trend<0.001), and a lower SRH by 0.05 points (95% CI: 0.02–0.08, P-for-trend<0.001). Conclusion We demonstrate that DAH is positively associated with important patient-reported outcomes among the dementia population, strengthening the argument for considering DAH as a meaningful outcome measure for PLWD.

中文翻译：

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痴呆患者在家度过的天数与功能状态和健康状况之间的关联


背景 许多痴呆症患者 （PLWD） 更愿意尽可能长时间地呆在家里，而在家度过的天数 （DAH）——定义为个人在医疗机构之外度过的时间——已成为该人群中以人为本的结果测量。我们检查了 PLWD 中 DAH 与功能状态和健康状况之间的关联。方法 利用 2010-2018 年健康与退休研究 （HRS） 中具有全国代表性的美国 65 岁及以上痴呆患者队列，我们评估了顺序分类 DAH 变量与日常生活活动数量 （ADLs） 之间的关系（范围 0-10;10 为独立）、流动性（0-5;5 为移动）， 和自评健康 （SRH） （0-4;4 为优秀），控制患者特征。DAH 被定义为在调查波之间的时间内，自我报告在医院或疗养院外度过的天数，通常为 730 天。结果 我们确定了 3002 名参与者 （4192 次观察，平均每位参与者 1.4 次观察）。平均 DAH 为 704.4 天 （SD 10.8 d），64.9% 的人全部在家中度过 （即 730 天）。DAH 降低 2 周与 ADL 评分降低 0.32 分相关 （95% 置信度内部 [CI]：0.24-0.40，P-趋势<0.001），流动性评分降低 0.18 分 （95% CI：0.13-0.22，P-趋势<0.001），SRH 降低 0.05 分 （95% CI：0.02-0.08，P 趋势<0.001）。结论 我们证明 DAH 与痴呆人群中重要的患者报告结果呈正相关，加强了将 DAH 视为 PLWD 有意义的结果测量的论点。