2026 Alzheimer’s Disease Facts and Figures
Medical Care
Implementation and Acceptance of Oral Health Assessment Tools in Residential Aged Care Facilities: A Scoping Review
This scoping review of 26 studies examined the implementation and acceptance of oral health assessment tools in long-term care communities. For non-dental professionals, barriers to implementing tools included insufficient training, high staff turnover, and inconsistent prioritizing of oral health, while facilitators included targeted training and the presence of oral health supporters. None of the included studies used an implementation science framework, despite the variety of tools identified in the review, indicating a gap in the clinical translation of the tools.
Implementation and Acceptance of Oral Health Assessment Tools in Residential Aged Care Facilities: A Scoping Review
This scoping review of 26 studies examined the implementation and acceptance of oral health assessment tools in long-term care communities. For non-dental professionals, barriers to implementing tools included insufficient training, high staff turnover, and inconsistent prioritizing of oral health, while facilitators included targeted training and the presence of oral health supporters. None of the included studies used an implementation science framework, despite the variety of tools identified in the review, indicating a gap in the clinical translation of the tools.
Vision Impairment is a Risk Factor for Malnutrition in Older Long-Term Care Residents
This Finnish study of over 2,500 residents from 47 AL communities and 7 nursing homes examined the relationship between vision and nutrition. Overall, 18% of participants had vision impairment; impairment was associated with malnutrition, as were chewing problems and Clinical Dementia Rating.
Vision Impairment is a Risk Factor for Malnutrition in Older Long-Term Care Residents
This Finnish study of over 2,500 residents from 47 AL communities and 7 nursing homes examined the relationship between vision and nutrition. Overall, 18% of participants had vision impairment; impairment was associated with malnutrition, as were chewing problems and Clinical Dementia Rating.
A Person-Centred Approach to Further Develop a Digital Tool (KOKU-Nut) by Developing a Nutrition Game for Older Adults Living in the Community
This qualitative study involved developing and testing Keep on Keep up (KOKU), a well-being app, through focus groups with 33 older adults in AL communities in the UK. The focus groups focused on nutrition and four themes emerged that helped develop the nutrition game: change in diet due to different aspects of aging, perception of food, choice of food, and perspectives about digital tools to support nutrition. The majority of participants had positive attitudes towards KOKU, and feeback from the testing group was generally positive, with high scores for usability.
A Person-Centred Approach to Further Develop a Digital Tool (KOKU-Nut) by Developing a Nutrition Game for Older Adults Living in the Community
This qualitative study involved developing and testing Keep on Keep up (KOKU), a well-being app, through focus groups with 33 older adults in AL communities in the UK. The focus groups focused on nutrition and four themes emerged that helped develop the nutrition game: change in diet due to different aspects of aging, perception of food, choice of food, and perspectives about digital tools to support nutrition. The majority of participants had positive attitudes towards KOKU, and feeback from the testing group was generally positive, with high scores for usability.
Virtual House Calls: Using Digital Health Technology for Populations in Assisted Living
This case study assessed the use of mobile telehealth technology during home visits in Canada. The case highlights potential to reduce care burden and enhance patient care by integrating multiple digital health technologies into house calls. However, barriers such as inconsistent access to funding and the need for consistent high-speed internet mean that the innovation may not be applicable to all assisted living residents.
Virtual House Calls: Using Digital Health Technology for Populations in Assisted Living
This case study assessed the use of mobile telehealth technology during home visits in Canada. The case highlights potential to reduce care burden and enhance patient care by integrating multiple digital health technologies into house calls. However, barriers such as inconsistent access to funding and the need for consistent high-speed internet mean that the innovation may not be applicable to all assisted living residents.
Challenges and Possibilities in Preventing Emerging Infectious Diseases in Long-Term Care: A Qualitative Descriptive Study
This qualitative study examined the experiences of 12 staff in Taiwanese long-term care communities related to preventing infectious disease during the COVID-19 pandemic. Two challenges emerged: inadequate preparation, and physical/emotional strain; and two areas for improvement emerged: ongoing education and the need for adaptive surveillance and tailored crisis response plans.
Challenges and Possibilities in Preventing Emerging Infectious Diseases in Long-Term Care: A Qualitative Descriptive Study
This qualitative study examined the experiences of 12 staff in Taiwanese long-term care communities related to preventing infectious disease during the COVID-19 pandemic. Two challenges emerged: inadequate preparation, and physical/emotional strain; and two areas for improvement emerged: ongoing education and the need for adaptive surveillance and tailored crisis response plans.
“What Good Is That?”-Perspectives of Using Telehealth to Discuss Serious Illness with Urban-Dwelling Low-Income Older Adults in Assisted Living
This qualitative study of 46 residents from 3 Medicaid-funded AL communities examined telehealth acceptance among low-income residents. Four themes emerged: the primary benefit (convenience), barrier (technology access and literacy), resident preference (ranging from enthusiasm to skepticism, but generally distasteful), and concerns (mistrust of providers). Overall, telehealth can improve convenience, but additional supports are needed to foster trust and effective therapeutic relationships.
“What Good Is That?”-Perspectives of Using Telehealth to Discuss Serious Illness with Urban-Dwelling Low-Income Older Adults in Assisted Living
This qualitative study of 46 residents from 3 Medicaid-funded AL communities examined telehealth acceptance among low-income residents. Four themes emerged: the primary benefit (convenience), barrier (technology access and literacy), resident preference (ranging from enthusiasm to skepticism, but generally distasteful), and concerns (mistrust of providers). Overall, telehealth can improve convenience, but additional supports are needed to foster trust and effective therapeutic relationships.
Comparing Outcomes Among Medicaid Home and Community-Based Service Users: Private Homes vs. Assisted Living Facilities
This study used 2016-2019 Medicare Claims data to compare outcomes (hospitalizations, emergency department visits, days at home, and Medicare spending) between 380,000 Medicare-Medicaid dual eligibles in two settings: home and community-based services (HCBS) users in private homes, and in AL communities (ALCs). Of these individuals, 85% were home-dwelling and 15% were in ALCs. In-home HCBS users worse outcomes; they had a higher likelihood of hospitalizations and emergency department visits and fewer days at home, as well as higher Medicaid spending as compared with ALC residents.
Comparing Outcomes Among Medicaid Home and Community-Based Service Users: Private Homes vs. Assisted Living Facilities
This study used 2016-2019 Medicare Claims data to compare outcomes (hospitalizations, emergency department visits, days at home, and Medicare spending) between 380,000 Medicare-Medicaid dual eligibles in two settings: home and community-based services (HCBS) users in private homes, and in AL communities (ALCs). Of these individuals, 85% were home-dwelling and 15% were in ALCs. In-home HCBS users worse outcomes; they had a higher likelihood of hospitalizations and emergency department visits and fewer days at home, as well as higher Medicaid spending as compared with ALC residents.
Disproportionate Impact of Respiratory Syncytial Virus (RSV) Among Older Adults in Long-Term Care Settings
This examined data from the the 2022 to 2024 respiratory syncytial virus (RSV) seasons in one county in New York to compare disease burden, hospitalization, and in-hospital deaths between older adults living in community and long-term care (LTC) settings. Overall, infection rates were highest in nursing homes; hospitalization rates were highest in AL communities; and in-hospital death rates were significantly higher in LTC settings than in community-dwelling older adults. Findings highlight older adults in LTC settings are disproportionately affected by RSV, showing the need for targeted RSV prevention strategies which could include vaccinations and improved detection.
Disproportionate Impact of Respiratory Syncytial Virus (RSV) Among Older Adults in Long-Term Care Settings
This examined data from the the 2022 to 2024 respiratory syncytial virus (RSV) seasons in one county in New York to compare disease burden, hospitalization, and in-hospital deaths between older adults living in community and long-term care (LTC) settings. Overall, infection rates were highest in nursing homes; hospitalization rates were highest in AL communities; and in-hospital death rates were significantly higher in LTC settings than in community-dwelling older adults. Findings highlight older adults in LTC settings are disproportionately affected by RSV, showing the need for targeted RSV prevention strategies which could include vaccinations and improved detection.
Obesity and Transition to Assisted Living Services in Older Adults: An Analysis from the National Health and Aging Trends Study
This analysis of data from the National Health and Aging Trends Study examined the relationship between 2 measures of obesity - body mass index (BMI) and waist circumference - and transitioning from community settings to AL services (TALS). Overall, rates of TALS were 26%, but with increasing BMI, risk of TALS decreased suggesting increased BMI may be a protective factor. However, further study is suggested to understand why this relationship may be occuring.
Obesity and Transition to Assisted Living Services in Older Adults: An Analysis from the National Health and Aging Trends Study
This analysis of data from the National Health and Aging Trends Study examined the relationship between 2 measures of obesity – body mass index (BMI) and waist circumference – and transitioning from community settings to AL services (TALS). Overall, rates of TALS were 26%, but with increasing BMI, risk of TALS decreased suggesting increased BMI may be a protective factor. However, further study is suggested to understand why this relationship may be occuring.
Mouth Care Without a Battle: Change in Assisted Living Staff Self-Efficacy and Attitudes
This study evaluated 24 AL communities to see if the modified Mouth Care Without a Battle (MCWB) for AL improved efficacy and attitudes of staff providing mouth care. AL staff's ratings of self-efficacy and attitudes did not significantly change after MCWB training, which differs from nursing home staff in another study. This may indicate AL staff do not view mouth care as high-priority, highlighting the need to emphasize it in training and supervision.
Mouth Care Without a Battle: Change in Assisted Living Staff Self-Efficacy and Attitudes
This study evaluated 24 AL communities to see if the modified Mouth Care Without a Battle (MCWB) for AL improved efficacy and attitudes of staff providing mouth care. AL staff’s ratings of self-efficacy and attitudes did not significantly change after MCWB training, which differs from nursing home staff in another study. This may indicate AL staff do not view mouth care as high-priority, highlighting the need to emphasize it in training and supervision.
Long Fever as a Long-Term Risk Factor for Mortality in Persons in Assisted Living Facilities
This study examined long-term impacts of fever as a risk factor for mortality up to two years post-fever using data from over 16,000 AL residents between 2012 and 2022. Compared with not having a fever, fever was significantly associated with increased mortality, as were higher temperature fevers and more days with fever. The findings showed that fever increased mortality risk, suggesting that "long-fever" may play a role and that fever should be incorporated into risk management strategies to enhance monitoring and care.
Long Fever as a Long-Term Risk Factor for Mortality in Persons in Assisted Living Facilities
This study examined long-term impacts of fever as a risk factor for mortality up to two years post-fever using data from over 16,000 AL residents between 2012 and 2022. Compared with not having a fever, fever was significantly associated with increased mortality, as were higher temperature fevers and more days with fever. The findings showed that fever increased mortality risk, suggesting that “long-fever” may play a role and that fever should be incorporated into risk management strategies to enhance monitoring and care.
Denture Care in Assisted Living: Best Practices and Clinical Importance for Resident Health
This editorial discusses the implications of denture management in long-term care settings, focusing on barriers to consistent removal, the risks of continuous wear, and the nutritional consequences of poor denture fit. Strategies focusing on infection prevention, adequate nutrition, integrating tasks into routine workflows, and engaging both staff and families are presented to improve denture care.
Denture Care in Assisted Living: Best Practices and Clinical Importance for Resident Health
This editorial discusses the implications of denture management in long-term care settings, focusing on barriers to consistent removal, the risks of continuous wear, and the nutritional consequences of poor denture fit. Strategies focusing on infection prevention, adequate nutrition, integrating tasks into routine workflows, and engaging both staff and families are presented to improve denture care.
“There Should Be a Nurse on Call”: Complex Care Needs of Low-Income Older Adults in Medicaid-Supported Assisted Living
This qualitative study explored the care needs and serious illness communication challenges of 17 residents of a Medicaid-supported AL community in New York. Four themes emerged: decreased quality of life, high burden from symptoms and low access to care, feeling unheard due to healthcare communication gaps, and uncoordinated care adding to feelings of distrust in the health system, indicating a need for policy changes related to care access and communication.
“There Should Be a Nurse on Call”: Complex Care Needs of Low-Income Older Adults in Medicaid-Supported Assisted Living
This qualitative study explored the care needs and serious illness communication challenges of 17 residents of a Medicaid-supported AL community in New York. Four themes emerged: decreased quality of life, high burden from symptoms and low access to care, feeling unheard due to healthcare communication gaps, and uncoordinated care adding to feelings of distrust in the health system, indicating a need for policy changes related to care access and communication.
Emergency Department Care Coordination Program for Assisted Living Residents with Dementia: A Qualitative Study
This qualitative study used data from 12 complex care managers (CCMs) in Florida and Minnesota to assess their perceptions of a care coordination program designed to improve communication related to transfers from AL communities to the emergency department (ED). Generally, the CCMs perceived the program as positively affecting both the ED experience for residents and goal-concordant care. Strengths of the program included CCM advocacy for patients and program adaptability, while a lack of knowledge about the program among ED staff and a lack of 24-hour coverage for CCMs were identified as areas for improvement.
Emergency Department Care Coordination Program for Assisted Living Residents with Dementia: A Qualitative Study
This qualitative study used data from 12 complex care managers (CCMs) in Florida and Minnesota to assess their perceptions of a care coordination program designed to improve communication related to transfers from AL communities to the emergency department (ED). Generally, the CCMs perceived the program as positively affecting both the ED experience for residents and goal-concordant care. Strengths of the program included CCM advocacy for patients and program adaptability, while a lack of knowledge about the program among ED staff and a lack of 24-hour coverage for CCMs were identified as areas for improvement.
Yearlong Evaluation of Fall Risk Determinants Among 40 Older Adults in Two Residential Assisted Living Facilities
This study examined the relationships among the physical activity, physical performance, falls, and cognitive functioning of 40 residents of 2 AL communities in Wisconsin. Up to 40% of participants had at least 1 fall in 6 months, and a significant association was found between number of falls, fear of falling, and a number of physical and cognitive measurements, offering new potential intervention points to reduce falls.
Yearlong Evaluation of Fall Risk Determinants Among 40 Older Adults in Two Residential Assisted Living Facilities
This study examined the relationships among the physical activity, physical performance, falls, and cognitive functioning of 40 residents of 2 AL communities in Wisconsin. Up to 40% of participants had at least 1 fall in 6 months, and a significant association was found between number of falls, fear of falling, and a number of physical and cognitive measurements, offering new potential intervention points to reduce falls.
Emergency Department Discharges Following Falls in Residential Aged Care Residents: A Scoping Review
This scoping review included 9 articles examining emergency department (ED) transfers after long-term care (LTC) resident falls. The average discharge rate from the ED back to LTC communties without a hospitalization was 63%, and brain scan findings, when reported, were not significantly influential in making discharge decisions. The findings highlight the importance of implementing geriatric-specific and person-centered protocols to reduce unnecessary ED transfers after falls.
Emergency Department Discharges Following Falls in Residential Aged Care Residents: A Scoping Review
This scoping review included 9 articles examining emergency department (ED) transfers after long-term care (LTC) resident falls. The average discharge rate from the ED back to LTC communties without a hospitalization was 63%, and brain scan findings, when reported, were not significantly influential in making discharge decisions. The findings highlight the importance of implementing geriatric-specific and person-centered protocols to reduce unnecessary ED transfers after falls.
Urinary Incontinence Is an Independent Risk Factor for Nursing Home Placement among Assisted Living Residents
WHAT THIS MEANS FOR YOU: This retrospective cohort study used 2019-2021 Medicare data to evaluate if urinary incontinence (UI) is an independent risk factor for assisted living residents' nursing home (NH) placement. Out of 247,010 residents, 20.5% had UI, and out of the 15.7% that were placed in NH, 21.7% had UI. The study confirmed that UI is an independent risk factor associated with NH placement, indicating education and early identification/treatment of UI will be helpful for avoiding/delaying NH placement.
Urinary Incontinence Is an Independent Risk Factor for Nursing Home Placement among Assisted Living Residents
WHAT THIS MEANS FOR YOU: This retrospective cohort study used 2019-2021 Medicare data to evaluate if urinary incontinence (UI) is an independent risk factor for assisted living residents’ nursing home (NH) placement. Out of 247,010 residents, 20.5% had UI, and out of the 15.7% that were placed in NH, 21.7% had UI. The study confirmed that UI is an independent risk factor associated with NH placement, indicating education and early identification/treatment of UI will be helpful for avoiding/delaying NH placement.
Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities
WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.
Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities
WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.
Medical Care Provider Involvement in Ontario Assisted Living Homes: A Descriptive Cross-Sectional Survey Analysis
WHAT THIS MEANS FOR YOU: This cross-sectional Canadian study examined 88 AL communities' survey responses to assess medical care provider involvement. A total of 54 AL communities had an established medical care provider, and doctors cared for more than 50 patients in 36% of homes and 46% visited homes weekly. Almost two-thirds of communities had nurses accompany physicians on rounds, and two-thirds provided residents with palliative care. Residents in homes with medical care providers were 76% less likely to seek care from a physician in the community.
Medical Care Provider Involvement in Ontario Assisted Living Homes: A Descriptive Cross-Sectional Survey Analysis
WHAT THIS MEANS FOR YOU: This cross-sectional Canadian study examined 88 AL communities’ survey responses to assess medical care provider involvement. A total of 54 AL communities had an established medical care provider, and doctors cared for more than 50 patients in 36% of homes and 46% visited homes weekly. Almost two-thirds of communities had nurses accompany physicians on rounds, and two-thirds provided residents with palliative care. Residents in homes with medical care providers were 76% less likely to seek care from a physician in the community.
Residency in Long-Term Care Facilities: An Important Risk Factor for Respiratory Syncytial Virus Hospitalization
WHAT THIS MEANS FOR YOU: This three-year prospective study in New York examined residential long-term care settings and risk associated with hospitalization due to respiratory syncytial virus (RSV), as compared with their community-dwelling peers. Residents in AL and NH settings were more likely to have dementia and congestive heart failure, creating intersections of risk factors for RSV. Residents of AL communities had 3-9 times higher, and residents of SNFs had 3-4 times higher, rates of RSV-associated hospitalizations than community dwelling residents. This study demonstrates the need for RSV vaccine recommendations in long-term care.
Residency in Long-Term Care Facilities: An Important Risk Factor for Respiratory Syncytial Virus Hospitalization
WHAT THIS MEANS FOR YOU: This three-year prospective study in New York examined residential long-term care settings and risk associated with hospitalization due to respiratory syncytial virus (RSV), as compared with their community-dwelling peers. Residents in AL and NH settings were more likely to have dementia and congestive heart failure, creating intersections of risk factors for RSV. Residents of AL communities had 3-9 times higher, and residents of SNFs had 3-4 times higher, rates of RSV-associated hospitalizations than community dwelling residents. This study demonstrates the need for RSV vaccine recommendations in long-term care.
Paucity of Published Data and Protocols for Hypoglycemia Management in Long-term Care
WHAT THIS MEANS FOR YOU: This systematic review examined established hypoglycemia protocols in LTC settings and assessed their effects on patient outcomes and healthcare resource use. Only 5 articles met the inclusion criteria and only 2 publications involved specific treatment protocols in long-term care settings, indicating a lack of published research on this issue.
Paucity of Published Data and Protocols for Hypoglycemia Management in Long-term Care
WHAT THIS MEANS FOR YOU: This systematic review examined established hypoglycemia protocols in LTC settings and assessed their effects on patient outcomes and healthcare resource use. Only 5 articles met the inclusion criteria and only 2 publications involved specific treatment protocols in long-term care settings, indicating a lack of published research on this issue.
Postimplementation Evaluation in Assisted Living Facilities of an eHealth Medical Device Developed to Predict and Avoid Unplanned Hospitalizations: Pragmatic Trial
WHAT THIS MEANS FOR YOU: This study tested a new monitoring system to predict risk of emergency hospitalizations in seven French AL communities. For the 118 included residents, 38 emergency hospitalizations were documented, and 50% of alerts from the system led to health care interventions. Hospitalizations were correlated with a lack of alert-triggered interventions, suggesting the system leads to improvements.
Postimplementation Evaluation in Assisted Living Facilities of an eHealth Medical Device Developed to Predict and Avoid Unplanned Hospitalizations: Pragmatic Trial
WHAT THIS MEANS FOR YOU: This study tested a new monitoring system to predict risk of emergency hospitalizations in seven French AL communities. For the 118 included residents, 38 emergency hospitalizations were documented, and 50% of alerts from the system led to health care interventions. Hospitalizations were correlated with a lack of alert-triggered interventions, suggesting the system leads to improvements.
Examining Care Network Characteristics in Older Adults’ Relocation to Residential Care Settings
WHAT THIS MEANS FOR YOU: This study used data from the National Health and Aging Trends Study to examine risk associated with older adults transitioning to residential care, specifically their care networks (involvement of multiple helpers). A total of 7,085 initially community-dwelling older adults were followed over 8 years, and the greatest risk for transitioning was having a care network with shared medical tasks, followed by sharing household tasks. Shared mobility, transportation, or self-care responsibilities decreased the risk. Having a close family member as a primary caregiver could act as a protective factor that decreases risk of transitioning into residential care.
Examining Care Network Characteristics in Older Adults’ Relocation to Residential Care Settings
WHAT THIS MEANS FOR YOU: This study used data from the National Health and Aging Trends Study to examine risk associated with older adults transitioning to residential care, specifically their care networks (involvement of multiple helpers). A total of 7,085 initially community-dwelling older adults were followed over 8 years, and the greatest risk for transitioning was having a care network with shared medical tasks, followed by sharing household tasks. Shared mobility, transportation, or self-care responsibilities decreased the risk. Having a close family member as a primary caregiver could act as a protective factor that decreases risk of transitioning into residential care.
