Longitudinal Effects of Activities, Social Environment, and Psychotropic Medication Use on Behavioral Symptoms of Individuals With Alzheimer's Disease in Nursing Homes

J Psychosoc Nurs Ment Health Serv. 2018 Nov 1;56(11):18-26. doi: 10.3928/02793695-20180503-04. Epub 2018 May 9.


A secondary data analysis of 25,560 minutes of structured clinical observations from a longitudinal study examined the impact of time-varying background factors, social environment, and psychotropic medication use on behavioral symptoms of nursing home residents with Alzheimer's disease (AD). Data were collected at baseline (N = 177), 12 months (N = 138), and 24 months (N = 111). Mixed-effects regression modeling showed that at 24 months: (a) higher cognitive and physical function and having a private bedroom/bathroom had the most positive influence on resident positive behaviors; (b) use of antipsychotic medications and solitary activities had the most negative influence on resident positive behaviors; (c) higher cognitive function significantly decreased negative behaviors; and (d) care-related activities and total number of psychotropic medications significantly increased negative behaviors. The current study describes risk factors for behavioral disturbances and the impact of activities, social environment, and psychotropic medications on behavioral outcomes in nursing home residents with AD. [Journal of Psychosocial Nursing and Mental Health Services, 56(11), 18-26.].

MeSH terms

  • Activities of Daily Living
  • Aged, 80 and over
  • Alzheimer Disease / drug therapy*
  • Behavioral Symptoms / psychology*
  • Cognition / physiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Nursing Homes*
  • Psychotropic Drugs / therapeutic use*
  • Risk Factors
  • Social Environment*


  • Psychotropic Drugs