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56/100

✓ Peer-reviewed alzhub usefulness score 56 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Plain-language summary

Objectives To identify characteristics of nursing home (NH) residents with advanced dementia and their healthcare proxies (HCPs) associated with hospice referral and to examine the association between hospice use and the treatment of pain and dyspnea and unmet needs during the last 7 days of life. Design Prospective cohort study. Setting Twenty-two Boston-area NHs. Participants Three hundred twenty-three NH residents with advanced dementia and their HCPs. Measurements Data were collected at baseline and quarterly for up to 18 months. Hospice referral, frequency of pain and dyspnea, and treatment of these symptoms was ascertained. HCPs reported unmet needs during the last 7 days of the residents' lives for communication, information, emotional support, and help with personal care. Results Twenty-two percent of residents were referred to hospice. After multivariable adjustment, factors associated with hospice referral were nonwhite race, eating problems, HCP's perception that the resident's had less than 6 months to live, and better HCP mental health. Residents in hospice were more likely to receive scheduled opioids for pain (adjusted odds ratio (AOR)=3.16; 95% confidence interval (95% CI)=1.57-6.36) and oxygen, morphine, scopolamine, or hyoscyamine for dyspnea (AOR=3.28, 95% CI=1.37-7.86). HCPs of residents in hospice reported fewer unmet needs in all domains during the last 7 days of the residents' life. Conclusion A minority of NH residents with advanced dementia received hospice care. Hospice recipients were more likely to received scheduled opioids for pain and symptomatic treatment for dyspnea and had fewer unmet needs at the end of life.

What this study adds

Evidence grade: Moderate

This is a follow-up (cohort) study. In this study of nursing home residents with advanced dementia, 22% were referred to hospice, and those in hospice were more likely to receive treatment for pain and dyspnea and their caregivers reported fewer unmet needs. Reported effect size: AOR=3.28.

Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Kiely, D. K., Givens, J. L., Shaffer, M. L., Teno, J. M., & Mitchell, S. L. (2010). Hospice use and outcomes in nursing home residents with advanced dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2010.03185.x

Vancouver

Kiely DK, Givens JL, Shaffer ML, Teno JM, Mitchell SL. Hospice use and outcomes in nursing home residents with advanced dementia. Journal of the American Geriatrics Society. 2010. doi:10.1111/j.1532-5415.2010.03185.x. PMID: 21143437.

BibTeX

@article{kiely2010-21143437,
  author  = {Kiely, D. K. and Givens, J. L. and Shaffer, M. L. and Teno, J. M. and Mitchell, S. L.},
  title   = {{Hospice use and outcomes in nursing home residents with advanced dementia}},
  journal = {Journal of the American Geriatrics Society},
  year    = {2010},
  doi     = {10.1111/j.1532-5415.2010.03185.x},
  pmid    = {21143437},
  url     = {https://doi.org/10.1111/j.1532-5415.2010.03185.x}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

How to read this study

Design: this is a follow-up (cohort) study. People are observed over time and not assigned to anything, so an association can reflect other differences between groups. Look at how long follow-up lasted, how many dropped out, and whether the authors adjusted for age, education and other health conditions.
Size: the record gives no participant count. Look for one in the original before trusting a pattern.
Effect: the record reports “AOR=3.28”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded moderate. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Moderate means the abstract mentions a cohort, case-control or longitudinal design. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Objectives To identify characteristics of nursing home (NH) residents with advanced dementia and their healthcare proxies (HCPs) associated with hospice referral and to examine the association between hospice use and the treatment of pain and dyspnea and unmet needs during the last 7 days of life.
Results Twenty-two percent of residents were referred to hospice.
After multivariable adjustment, factors associated with hospice referral were nonwhite race, eating problems, HCP's perception that the resident's had less than 6 months to live, and better HCP mental health.

Why it matters

In this study of nursing home residents with advanced dementia, 22% were referred to hospice, and those in hospice were more likely to receive treatment for pain and dyspnea and their caregivers reported fewer unmet needs. It concerns end-of-life care and does not test a treatment, cure or prevention for Alzheimer's disease.

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Study details

Study designcohort study
Effect sizeAOR=3.28
Evidence strengthModerate

How this study scored 56/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society)
Journal's citation record	3 / 4	Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2010 — within 20 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 119 times (OpenAlex, 2026-10-10)
Citations per year	2 / 5	6.6 citations a year over 18 year(s) since 2010
Impact for its field and year	3 / 6	Cited 5.1× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 11 other studies in this library
Still being cited	2 / 4	Cited 18 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Susan L. Mitchell: h-index 70 (OpenAlex, whole career)
Institution's track record	1 / 3	Pennsylvania State University: institution h-index 1,397 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 4 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 21143437)
Free to read	0 / 2	Behind a paywall — scores zero
Total	56 / 100	—

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