Predictors of caregiver unawareness and nontreatment of dementia among residents of assisted living facilities: The Maryland assisted living study

Donovan T. Maust, Chiadi U. Onyike, Jeannie Marie E. Sheppard, Lawrence S. Mayer, Quincy M. Samus, Jason Brandt, Peter V. Rabins, Constantine G. Lyketsos, Adam Rosenblatt

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: Assisted living (AL) is a rapidly expanding residential option for the senior population. With increased utilization, it becomes important to understand the detection and treatment of dementia in this setting, but little is known. The objective of this study was to identify and evaluate factors associated with caregiver unawareness of dementia and failure to treat dementia in AL. Methods: The setting was a cross-sectional study of a random sample of AL facilities in central Maryland (The Maryland Assisted Living Study). Geriatric psychiatrists evaluated 198 participants and assigned dementia diagnoses to 134 residents (67.7%). The extent to which dementia was recognized and treated in these facilities was estimated on the basis of caregiver interview and chart review data. Using logistic regression models, demographic, cognitive, and functional measures were evaluated as predictors of caregiver unawareness and nontreatment of dementia. Results: Severity of cognitive and functional impairment, number of neuropsychiatric symptoms, and male gender were all independent predictors of caregiver unawareness of dementia. Family and caregiver unawareness of dementia and female gender were predictors of failure to treat dementia. Detection and treatment were not associated with race, age, or overall medical health. Conclusions: Caregivers were more likely to be unaware of dementia in residents who did not have severe cognitive impairment or obvious behavioral and functional problems. Caregiver and family unawareness were in turn associated with nontreatment. Observed gender differences in detection and treatment will require replication and further study. These observations suggest that systematic educational interventions for caregivers and families may improve detection and hence treatment in the AL setting.

Original languageEnglish (US)
Pages (from-to)668-675
Number of pages8
JournalAmerican Journal of Geriatric Psychiatry
Issue number8
StatePublished - Aug 2006
Externally publishedYes


  • Assisted living
  • Dementia awareness
  • Treatment

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


Dive into the research topics of 'Predictors of caregiver unawareness and nontreatment of dementia among residents of assisted living facilities: The Maryland assisted living study'. Together they form a unique fingerprint.

Cite this