2026-10-08T06:31:30Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34033491 2026-09-30T15:36:51Z category_427 portal_316 item_type_3 month_year_09_2026

Table 1_Monitoring of palliative care outcomes for nursing home residents with dementia: a secondary exploratory analysis of monthly recurrent deterioration data.docx Stefania Serban (25144698) Bogdan Neamtu (25144701) Daniela Viorica Mosoiu (25144704) Adrian Cosmin Ilie (8654031) Estera Boeriu (25144707) Maria-Mirabela Mihailescu-Marin (17703493) Public Health and Health Services not elsewhere classified dementia IPOS-Dem nursing homes palliative care predictive modeling recurrent deterioration secondary analysis Background<p>In long-term care facilities, regular proxy-completed multidimensional assessments may help staff detect meaningful decline in residents with dementia, including temporal changes in physical symptoms, mood, behavior, and social interaction.</p>Methods<p>We conducted a secondary analysis of publicly available, de-identified longitudinal IPOS-Dem data from a Swiss stepped-wedge cluster-randomized trial to develop and evaluate a concise resident-level model predicting recurrent short-term deterioration on IPOS-Dem subscales among Swiss long-term care residents with dementia. Monthly observations were converted into prediction episodes. Deterioration was prospectively defined as a ≥0.5-point increase in DEBI (dementia emotional and behavioral impact-reflecting emotional and behavioral symptoms) or DPII (dementia physical/interaction impact indicating physical, functional, communication, and interaction-related concerns) at the next observation within 14–45 days. Recurrent deterioration was defined as deterioration in >33% of eligible episodes. Candidate logistic-regression predictors included mean DEBI/DPII, recent monthly DEBI/DPII changes, age, sex, intervention exposure, study-time variables, cluster group, and DEBI × DPII.</p>Results<p>The episode-level dataset included 2,107 eligible prediction episodes from 222 residents; 535 episodes deteriorated (25.4%), and 72/222 residents (32.4%) met recurrent-deterioration criteria. In the final model, higher mean-centered DEBI increased the odds of recurrent deterioration (OR 2.655, 95% CI 1.382–5.101, p = 0.003), as did older age (OR 1.055/year, 95% CI 1.006–1.107, p = 0.027). Mean-centered dDEBI reduced risk (OR 0.089, 95% CI 0.009–0.873, p = 0.038). DEBI × DPII was significant (OR 0.341, 95% CI 0.118–0.991, p = 0.048). Performance was reasonable (AUC 0.754; Brier 0.179).</p>Conclusion<p>Serial IPOS-Dem monitoring provides actionable indicators of level and trajectory for recurrent deterioration. External validation and longitudinal modeling are needed to address resident- and facility-level dependence.</p> 2026-09-30T15:36:51Z Dataset Dataset 10.3389/fpubh.2026.1874583.s001 https://figshare.com/articles/dataset/Table_1_Monitoring_of_palliative_care_outcomes_for_nursing_home_residents_with_dementia_a_secondary_exploratory_analysis_of_monthly_recurrent_deterioration_data_docx/34033491 CC BY 4.0