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44/100

✓ Peer-reviewed alzhub usefulness score 44 out of 100. Risk factors

Topic: Risk, prevention and care in population studies

Limited data suggest nursing home (NH) Alzheimer's special care units (ASCUs) may improve care and outcomes among residents with dementia. Unfortunately, information describing NH characteristics related to presence of ASCUs is lacking, especially whether location and neighborhood resources influence their presence. We examined locations of NHs with ASCUs and assessed whether neighborhood socioeconomic deprivation, region, and levels of rurality were associated with NH ASCUs. Cross-sectional. Contiguous United States; we used 2017 LTCfocus and NH Compare data to identify free-standing NHs and obtain addresses (N = 13,207 NHs). NH ZIP+4 codes were linked to the Area Deprivation Index (ADI) (within-state ranking of neighborhood deprivation). The 9 census-defined regions of the United States and Rural Urban Continuum codes categorized location. Descriptive analyses and binary logistic regression models, adjusting for NH characteristics, examined associations between NH ASCUs and location. Nearly 15% of NHs had ASCUs. In adjusted models, odds of NH ASCUs were 58% to 69% lower in Pacific, Middle Atlantic, and Southern regions compared with the East North Central region (P values <.001). Odds of NH ASCUs increased 25% to 47% as rurality increased relative to NHs in the most metropolitan areas (P < .01); however, odds of NH ASCUs decreased 63% in the most rural areas (P < .001). ADI was not significantly associated with NH ASCUs. For-profit NHs had 42% lower and chain-affiliated NHs 34% higher odds of ASCUs (P < .001). NHs with higher total staffing hours had 29% higher odds of ASCUs; odds of ASCUs were 46% lower in NHs with more RN staffing hours (P < .001). Using a robust sample, region, rurality, ownership, and nursing hours significantly predicted NH ASCUs whereas ADI did not. Geographically tailored interventions should be considered to promote use of NH-based ASCUs.

Key findings

We examined locations of NHs with ASCUs and assessed whether neighborhood socioeconomic deprivation, region, and levels of rurality were associated with NH ASCUs.
In adjusted models, odds of NH ASCUs were 58% to 69% lower in Pacific, Middle Atlantic, and Southern regions compared with the East North Central region (P values <.001).
ADI was not significantly associated with NH ASCUs.
For-profit NHs had 42% lower and chain-affiliated NHs 34% higher odds of ASCUs (P < .001).
NHs with higher total staffing hours had 29% higher odds of ASCUs; odds of ASCUs were 46% lower in NHs with more RN staffing hours (P < .001).

Why it matters

This study found that nursing home Alzheimer's special care units varied by region and rurality, while neighborhood deprivation was not significantly associated with their presence. It describes where these units are located and does not test whether they improve outcomes.

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Study details

Study designcross-sectional
Participants13,207
Evidence strengthLow

How this study scored 44/100

Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of the American Medical Directors Association)
Journal's citation record	2 / 4	Journal of the American Medical Directors Association: journal h-index 172 (OpenAlex, 2026-10-29)
Study design	4 / 12	A snapshot of people at one point in time
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2022 — within 6 year(s) of the newest study here
Sample size	4 / 4	13,207 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	2 / 7	Cited 7 times (OpenAlex, 2026-10-10)
Citations per year	1 / 5	1.2 citations a year over 6 year(s) since 2022
Impact for its field and year	1 / 6	Cited 0.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	1 / 4	Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author John G. Cagle: h-index 28 (OpenAlex, whole career)
Institution's track record	1 / 3	University of Maryland, Baltimore: institution h-index 970 (OpenAlex)
Multi-centre collaboration	0 / 3	OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete)
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 34411539)
Free to read	0 / 2	Behind a paywall — scores zero
Total	44 / 100	—

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Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

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

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.

APA 7th

Jessica, O., & Cagle John, G. (2022). Nursing Home Alzheimer's Special Care Units: Geographic Location Matters. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2021.07.020

Vancouver

Jessica O, Cagle John G. Nursing Home Alzheimer's Special Care Units: Geographic Location Matters. Journal of the American Medical Directors Association. 2022. doi:10.1016/j.jamda.2021.07.020. PMID: 34411539.

BibTeX

@article{jessica2022-34411539,
  author  = {Jessica, Orth and Cagle John, G.},
  title   = {{Nursing Home Alzheimer's Special Care Units: Geographic Location Matters}},
  journal = {Journal of the American Medical Directors Association},
  year    = {2022},
  doi     = {10.1016/j.jamda.2021.07.020},
  pmid    = {34411539},
  url     = {https://doi.org/10.1016/j.jamda.2021.07.020}
}

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