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Psychosis symptoms in nursing home residents with and without dementia - cross-sectional analyses from the COSMOS study.

OBJECTIVE: To investigate the characteristics of nursing home residents with psychosis and the association with potential underlying factors, such as pain, sleep disturbances, and antipsychotic medication.

METHOD: 545 residents with and without dementia from 67 Norwegian nursing home units were included in the cross sectional analyses. Psychosis was the main outcome measure in our study; other outcome measures include quality of life (QoL), ADL function, cognitive function, pain, and antipsychotic medication.

RESULTS: 112 residents had one or more symptoms of psychosis, and compared to residents without psychosis, they had lower QoL (p <0.001), ADL function (p = 0.003) and cognitive functioning (p = 0.001). Adjusted logistic regression analyses showed that psychosis was associated with the prevalence of pain (OR: 3.19, 95% CI: 1.94-5.24), sleep disturbances (OR: 4.51, 95% CI: 2.91-6.99), and total number of medication (OR: 1.10, 95% CI: 1.03-1.17). Residents with psychosis but without antipsychotic medication, had better quality of life (p = 0.005) compared with residents receiving any antipsychotics.

CONCLUSION: Psychosis in NH residents is associated with pain, sleep disturbances and number of medications. Residents with psychosis have poor quality of life, though better quality of life was observed among those who did not use antipsychotic medication.

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