SRF015: COVID 19 associated cognitive, functional, and mood changes in an ‘un-infected’ Virginia long term care facility

J. Kerns, MD; Nelson McKay, MD; Nauras Hwig; Elena Messina, MD; Andrew French, DO; Camelia Soliman, MD


CONTEXT: Anecdotal evidence indicates that the efforts of long term care facilities (LTCF) to prevent COVID 19 infection have resulted in adverse changes in residents’ quality of life. Staff in one LTCF report that the use of video, barrier protected visual contact, and enhanced structured activities have not prevented declines in resident mood, cognition, and functional status. Understanding which particular areas of these domains might be affected could assist this and other LTCF staffs to more precisely identify and address these challenges. While second quarter (Q2) CMS required Minimal Data Set reports will not be available until the end of 2020, quarterly de-identified data for this LTCF is available, including the COVID affected Q2 of 2020.
OBJECTIVE: Compare one LTCF residents’ mood, cognition, and functional capacity assessments between Q1 and Q2 of 2020, and compare those changes to Q1 vs. Q2 of 2019. 2) Since LTCF resident parameters may change year to year, also compare changes of Q1 2019 to Q1 2020 with changes from Q2 2019 to Q2 2020. 3) Evaluate any correlations in summative measures of mood, cognition, and functional status for each quarterly comparison; changes in one may cause changes in the other two.
HUMAN SUBJECT REVIEW: IRB approval: Valley Health, Winchester, Virginia.
DESIGN: Retrospective cohort study of LTCF de-identified data for the domains of mood, cognition, and functional status. Such data is summative for each domain, but are composed of multiple scored assessments (e.g. PHQ9, geriatric anxiety scale, etc.). We anticipate Mann Whitney for expected non-parametric continuous data, chi square for categorical data, and Pearson correlation analysis.
SETTING/PARTICIPANTS: 50 non-Hospice LTCF residents who have been continuously in the facility from 1/1/2019 to 6/30/2020.
OUTCOMES: Summative changes in measures of mood, cognition, functional status associated with COVID 19 precautions, correlations between those changes, and subset analyses of validated assessments of mood, cognition, and function.
ANTICIPATED RESULTS: We anticipate identifying significant changes in specific assessments of resident wellbeing in order to inform efforts to mitigate them.
CONCLUSIONS: Assessing changes in existing LTCF measures due to COVID 19 prevention may lead to improved efforts to address any negative impact on mood, cognition, and functional status of residents locally, as well as informing such efforts in other facilities.
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Jack 11/21/2020

great project. thanks for sharing with NAPCRG

Nauras Hwig 11/21/2020

If there are any questions or comments about our project, please don't hesitate to reach out. Thank you.

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