{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:17:08Z","timestamp":1783415828312,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K08 AG071856"],"award-info":[{"award-number":["K08 AG071856"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23 AG066864"],"award-info":[{"award-number":["K23 AG066864"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01 P01AG027296\u201013"],"award-info":[{"award-number":["P01 P01AG027296\u201013"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic significantly disrupted nursing home (NH) care, including visitation restrictions, reduced staffing levels, and changes in routine care. These challenges may have led to increased behavioral symptoms, depression symptoms, and central nervous system (CNS)\u2010active medication use among long\u2010stay NH residents with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, cross\u2010sectional study including Michigan long\u2010stay (\u2265100\u2009days) NH residents aged \u226565 with dementia based on Minimum Data Set (MDS) assessments from January 1, 2018 to June 30, 2021. Residents with schizophrenia, Tourette syndrome, or Huntington's disease were excluded. Outcomes were the monthly prevalence of behavioral symptoms (i.e., Agitated Reactive Behavior Scale\u2009\u2265\u20091), depression symptoms (i.e., Patient Health Questionnaire [PHQ]\u20149\u2009\u2265\u200910, reflecting at least moderate depression), and CNS\u2010active medication use (e.g., antipsychotics). Demographic, clinical, and facility characteristics were included. Using an interrupted time series design, we compared outcomes over two periods: Period 1: January 1, 2018\u2013February 28, 2020 (pre\u2010COVID\u201019) and Period 2: March 1, 2020\u2013June 30, 2021 (during COVID\u201019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 37,427 Michigan long\u2010stay NH residents with dementia. The majority were female, 80\u2009years or older, White, and resided in a for\u2010profit NH facility. The percent of NH residents with moderate depression symptoms increased during COVID\u201019 compared to pre\u2010COVID\u201019 (4.0% vs 2.9%, slope change [SC]\u00a0=\u00a00.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Antidepressant, antianxiety, antipsychotic and opioid use increased during COVID\u201019 compared to pre\u2010COVID\u201019 (SC\u00a0=\u00a00.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, SC\u00a0=\u00a00.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, SC\u00a0=\u00a00.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05, and SC\u00a0=\u00a00.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively). No significant changes in hypnotic use or behavioral symptoms were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Michigan long\u2010stay NH residents with dementia had a higher prevalence of depression symptoms and CNS active\u2010medication use during the COVID\u201019 pandemic than before. During periods of increased isolation, facility\u2010level policies to regularly assess depression symptoms and appropriate CNS\u2010active medication use are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18116","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T01:33:31Z","timestamp":1667957611000},"page":"414-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Behavioral symptoms, depression symptoms, and medication use in Michigan nursing home residents with dementia during\n                    <scp>COVID<\/scp>\n                    \u201019"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5723-0443","authenticated-orcid":false,"given":"Antoinette B.","family":"Coe","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy University of Michigan College of Pharmacy  Ann Arbor Michigan USA"},{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Montoya","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiang\u2010Hua","family":"Chang","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pil S.","family":"Park","sequence":"additional","affiliation":[{"name":"Institute of Gerontology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie P. W.","family":"Bynum","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"},{"name":"Institute of Gerontology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa I.","family":"Shireman","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Health Care Research Brown University School of Public Health  Providence RI USA"},{"name":"Department of Health Services Policy and Practice, Brown University School of Public Health  Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Health Care Research Brown University School of Public Health  Providence RI USA"},{"name":"Department of Health Services Policy and Practice, Brown University School of Public Health  Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-8220","authenticated-orcid":false,"given":"Ellen M.","family":"McCreedy","sequence":"additional","affiliation":[{"name":"Center for Gerontology and Health Care Research Brown University School of Public Health  Providence RI USA"},{"name":"Department of Health Services Policy and Practice, Brown University School of Public Health  Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1943-0150","authenticated-orcid":false,"given":"Lauren B.","family":"Gerlach","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Psychiatry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,8]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centers for Medicare & Medicaid Services. CMS announces new measures to protect nursing home residents from COVID\u201019. May 13 2020. Available at:https:\/\/www.cms.gov\/newsroom\/press-releases\/cms-announces-new-measures-protect-nursing-home-residents-covid-19. Accessed April 20 2022."},{"key":"e_1_2_10_3_1","unstructured":"Centers for Medicare & Medicaid Services. Guidance for infection control and prevention of Coronavirus Disease (COVID\u201019) in nursing homes (revised). March 13 2020. Available at:https:\/\/www.cms.gov\/files\/document\/qso-20-14-nh-revised.pdf. Accessed April 20 2022."},{"key":"e_1_2_10_4_1","unstructured":"Governor Gretchen Whitmer. Executive Order 2020\u201307: Temporary restrictions on entry into health care facilities residential care facilities congregate care facilities and juvenile justice facilities\u2014rescinded. March 14 2020. Available at:https:\/\/www.michigan.gov\/whitmer\/news\/state-orders-and-directives\/2020\/03\/14\/executive-order-2020-7. 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Version 1.17.1. 2019. Available at:https:\/\/downloads.cms.gov\/files\/mds-3.0-rai-manual-v1.17.1_october_2019.pdf. Accessed April 23 2021."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.08.030"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5074"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2022.02.011"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.18441"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17599"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.05.006"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.11.025"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0733464820958550"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1258\/135763303322225544"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113028"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.01239"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-210079"},{"key":"e_1_2_10_29_1","first-page":"170","article-title":"Analyzing topics and sentiments from twitter to gain insights to refine interventions for family caregivers of persons with Alzheimer's disease and related dementias (ADRD) during COVID\u201019 pandemic","volume":"289","author":"Yoon S","year":"2022","journal-title":"Stud Health Technol Inform"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.18116","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.18116","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.18116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T16:25:43Z","timestamp":1762187143000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.18116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,8]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/jgs.18116"],"URL":"https:\/\/doi.org\/10.1111\/jgs.18116","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,8]]},"assertion":[{"value":"2022-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}