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Background: The aim of this cross‐sectional study was to compare patterns of psychotropic prescription drug use among cognitively impaired residents in long‐term care facilities in East Asia and to explore factors associated with these patterns. Methods: This study included elderly participants with cognitive impairments residing in long‐term care facilities with and without dementia care units in Japan, South Korea, China, Taiwan, and Thailand. The Mini‐Mental State Examination, the Clinical Dementia Rating, and the Neuropsychiatric Inventory, Nursing Home version were used to assess cognitive status, examine dementia severity, and evaluate behavioural psychological symptoms of dementia, respectively. The rate of psychotropic drug use and the relationship between the number of psychotropic drugs and clinical factors were examined. Results: In total, 662 people were analyzed. Facilities with dementia care units had a higher rate of anti‐dementia drug use than regular elderly care sites. Among the three dementia care sites, a Japanese hospital and a Korean site had a high rate of antipsychotic use and use of other types of psychotropics, whereas these drugs were used at a low rate in a Chinese nursing home. Patterns of psychotropic drug use may be partially associated with local regulations and facility type. Poly‐pharmacy was identified as a common problem at all study sites. Conclusions: Our findings will be beneficial for health‐care professionals and policymakers when developing practice guidelines and strategies to regulate overuse of psychotropics and poly‐pharmacy. Prospective studies are needed to examine patterns of psychotropic prescriptions and to promote evidence‐based practice. [ABSTRACT FROM AUTHOR]

Aim: The current study was an international cross‐sectional study comparing the prevalence of incontinence among cognitively impaired older residents in long‐term care facilities in East Asia, including Japan, Korea, China, Taiwan and Thailand between 2015 and 2016. Methods: Participants were cognitively impaired older residents in long‐term care facilities. Demographic data were collected. The Clinical Dementia Rating scale was used to assess dementia severity, and the Barthel Index was used as a surrogate measure of incontinence and toilet use dependence. The prevalence of urinary incontinence and fecal incontinence were examined. Multiple logistic regression analysis was used to predict incontinence and toilet use dependence. Results: We analyzed data from 662 participants (age 82.6 ± 9.9 years, 57.6% women). The prevalence of urinary incontinence ranged from 10.1% in Taiwan to 71.0% in Korea. The prevalence of fecal incontinence varied from 4.0% in Taiwan to 57.0% in Korea. A higher Clinical Dementia Rating score was a significant predictor of urinary and fecal incontinence and toilet use dependence (P < 0.0001). Conclusions: The current survey showed a high prevalence of incontinence in long‐term care residents in East Asia, and identified challenges for future studies. Development of clinical guidelines for incontinence care in cognitively impaired older persons is urgently required. Geriatr Gerontol Int 2019; 19: 444–450. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the prevalence of behavioural and psychological symptoms of dementia (BPSD) in cognitively impaired elderly residents of long‐term care facilities in East Asia and to explore the factors associated with these patterns. Methods: This was a cross‐sectional survey of BPSD in cognitively impaired elderly residents of long‐term care facilities in Japan, South Korea, China, Taiwan, and Thailand. The Mini‐Mental State Examination, Clinical Dementia Rating (CDR), and Neuropsychiatric Inventory, Nursing Home version (NPI‐NH), were used to assess cognitive status, dementia severity, and BPSD, respectively. NPI‐NH subscale severity scores were multiplied by frequency scores to obtain the subscale scores and aggregated into two groups based on score (clinically insignificant = 1– 3; clinically significant ≥4). Results: Data from 662 people were analyzed. Median age, median Mini‐Mental State Examination scores, and median CDR scores differed significantly among the seven study sites. The prevalence of BPSD varied from 64% in Taiwan to 100% in dementia care units in Japan, and the median total NPI‐NH scores ranged from 2 in Taiwan to 14 in dementia care units in Japan. After stratification of the sample by dementia severity and clinical significance of NPI‐NH scores, differences in the prevalence of clinically significant BPSD were mostly observed among facilities dedicated to dementia patients in the CDR 1 group. In the CDR 3 group, the prevalence of some clinically significant BPSD, such as apathy, was high even among study sites with low median total NPI‐NH scores. Conclusions: Our findings may suggest referral and selection biases in the study sites. Future prospective studies are needed to address the impact of environmental and care factors on the occurrence of BPSD in Asian countries. [ABSTRACT FROM AUTHOR]