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Treatment of nursing home residents with dementia and lower respiratory tract infection in the United States and The Netherlands: an ocean apart
van der Steen JT, Kruse RL, Ooms ME, Ribbe MW, van der Wal G, Heintz LL, Mehr DR.. Journal of the American Geriatrics Society, 2004-05-01
Topic: Risk, prevention and care in population studies
Objectives To compare treatment of nursing home residents with dementia and lower respiratory tract infection (LRI) in Missouri and the Netherlands. Design Two separate but simultaneous prospective cohort studies. Setting Nursing homes in Missouri (n=36) and the Netherlands (n=61). Participants Selected residents (701 from Missouri and 551 from the Netherlands) diagnosed with LRI and dementia. Measurements Treatment, dementia severity, symptoms and signs of LRI, and general health condition were recorded at the time of diagnosis of LRI. Death was monitored at follow-up. Treatment and mortality, stratified for dementia severity, are reported. Results Treatment of nursing home-acquired LRI in Missouri residents involved a larger number of antibiotics, more frequent hospitalization, and greater use of intravenous antibiotics and rehydration therapy than in Dutch residents of equal dementia severity. Furthermore, for Missouri residents, intensive interventions were more often provided irrespective of severe dementia. By contrast, in both countries, treatments to relieve symptoms of LRI were provided for only a minority of residents. Dutch mortality rates were higher overall. Conclusion Care for U.S. nursing home residents with LRI and dementia is more aggressive than care for Dutch residents, particularly in residents with severe dementia. These results are relevant to the debate on optimal care in relation to curative or palliative treatment goals.
Key findings
- Results Treatment of nursing home-acquired LRI in Missouri residents involved a larger number of antibiotics, more frequent hospitalization, and greater use of intravenous antibiotics and rehydration therapy than in Dutch residents of equal dementia severity.
- Dutch mortality rates were higher overall.
- These results are relevant to the debate on optimal care in relation to curative or palliative treatment goals.
Why it matters
This cohort study found that U.S. nursing home residents with dementia and lower respiratory tract infection received more aggressive treatment than Dutch residents of equal dementia severity, while Dutch mortality rates were higher overall. It compares care practices and does not test any treatment or prevention for dementia itself.
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Study details
- Study designcohort study
- Participants36
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal, and it is a cohort study following people over 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 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 | 2004 — older than 20 years, still counted |
| Sample size | 1 / 4 | 36 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 | 5 / 7 | Cited 104 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.3 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 3 / 6 | Cited 7.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author David R. Mehr: h-index 49 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Amsterdam UMC Location Vrije Universiteit Amsterdam: institution h-index 938 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15086647) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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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. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
van der Steen, J. T., Kruse, R. L., Ooms, M. E., Ribbe, M. W., van der Wal, G., Heintz, L. L., et al. (2004). Treatment of nursing home residents with dementia and lower respiratory tract infection in the United States and The Netherlands: an ocean apart. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2004.52204.x
Vancouver
van der Steen JT, Kruse RL, Ooms ME, Ribbe MW, van der Wal G, Heintz LL, et al. Treatment of nursing home residents with dementia and lower respiratory tract infection in the United States and The Netherlands: an ocean apart. Journal of the American Geriatrics Society. 2004. doi:10.1111/j.1532-5415.2004.52204.x. PMID: 15086647.
BibTeX
@article{vandersteen2004-15086647,
author = {van der Steen, J. T. and Kruse, R. L. and Ooms, M. E. and Ribbe, M. W. and van der Wal, G. and Heintz, L. L. and Mehr, D. R.},
title = {{Treatment of nursing home residents with dementia and lower respiratory tract infection in the United States and The Netherlands: an ocean apart}},
journal = {Journal of the American Geriatrics Society},
year = {2004},
doi = {10.1111/j.1532-5415.2004.52204.x},
pmid = {15086647},
url = {https://doi.org/10.1111/j.1532-5415.2004.52204.x}
}
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