Social Connectedness among Long-Stay Nursing Home Residents with Alzheimer’s and Dementia: Exploring Individual and Facility-Level Variation

Abstract

<b><i>Introduction:</i></b> This study sought to explore individual and facility-level variation in social connectedness among long-stay nursing home residents with Alzheimer’s or other dementias (ADRD). <b><i>Methods:</i></b> We identified 721,074 long-stay residents with ADRD using 2016 Minimum Data Set 3.0 data. Social connectedness was defined using the social connectedness index (SCI) (high: SCI = 5, lower: 0 &#x3c; SCI ≤ 4). Adjusted odds ratios (aOR) provided estimates of the associations between resident-level and facility-level characteristics, and high SCI was derived from logistic models. <b><i>Results:</i></b> The SCI Cronbach’s alpha was 0.69; 78.6% had high SCI scores. Men were less likely than women to have higher SCI scores (aOR = 0.97; 95% CI: 0.97–0.98). Increasing age was associated with higher SCI scores (e.g., aOR [85–94 vs. 40–64 years]: 1.07; 95% CI: 1.06–1.07). Those with moderate cognitive impairment (aOR: 0.87) and severe cognitive impairment (aOR: 0.85) had reduced odds of SCI = 5 relative to those with mild/intact cognitive function. Residents living in homes with special care dementia units and with higher percentage of residents with dementia had decreased odds of high social connectedness. <b><i>Discussion/Conclusion:</i></b> Understanding resident- and nursing home-level variation in social connectedness may be important for targeting interventions that reduce isolation among residents with ADRD.