Table 20Cognitive function outcomes: U.S. longitudinal peer-reviewed studies

StudyMeasureResultRisk of Bias Rating
Pruchno and Rose, 200054Mean MMSE score over 1 year; range 0–30, with lower score indicating more impairmentThere were no significant time, time by facility, or facility effects (for AL versus NH) in the repeated ANOVA analysis, indicating that AL and NH residents had similar trends in cognitive ability over time.

Conclusions: Trends in cognitive ability for AL and NH residents were similar.
Collaborative Studies of Long-Term Care subsample
aSloane et al., 200562
Mean increase in cognitive impairment per 12 months; measure based on MDS-COGSResidents with mild dementia: AL 0.41, NH 0.71, p=0.181
Residents with moderate or severe dementia: AL -0.13, NH 0.45, p=0.093

Conclusions: Mean rates of decline in cognitive function did not differ between AL and NH residents for the cohort with mild dementia or for the cohort with moderate or severe dementia.
Marek et al., 200548Mean cognitive impairment; measured from MDS Cognitive Performance Scale, with a range of 0–6, where higher scores indicate greater impairment6 months: HCBS mean 0.8, NH mean 1.4, p=0.00
12 months: HCBS mean 0.7, NH mean 1.8, p=0.00
18 months: HCBS mean 0.6, NH mean 1.8, p=0.00
24 months: HCBS mean 0.8, NH mean 2.1, p=0.38

Conclusions: Cognition was significantly better in the HCBS group compared with the NH group at the 6-, 12-, and 18-month time periods, but not at the 24-month time period.

AL = Assisted Living; ANOVA = Analysis of Variance; HCBS = Home and Community-Based Services; MDS = Minimum Data Set; MDS-COGS = Minimum Data Set Cognition Scale; MMSE = Mini-Mental State Examination; NH = Nursing Home

Note: Table 16 reports analysis performed in each study.

Note: Table rows ordered by analyses of AL versus NH then by analyses of HCBS versus NH.


Study focused on samples with dementia.

From: Results

Cover of Long-Term Care for Older Adults
Long-Term Care for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care [Internet].
Comparative Effectiveness Reviews, No. 81.
Wysocki A, Butler M, Kane RL, et al.

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