Factors associated with care-resistant behavior in the National Alzheimer's Coordinating Center's Uniform Data Set

Little is known about the factors associated with care-resistant behavior in community-dwelling persons living with dementia.

Regression modeling was performed on 41,143 responses to a standardized questionnaire from the National Alzheimer's Coordinating Center's Uniform Data Set.

In the fully adjusted mixed-effects regression model, collinearity was low, with no variance inflation factor above 1.15. Moderate (adjusted odds ratio [aOR] = 1.59; 95% confidence interval [CI]: 1.50, 1.69) and severe (aOR = 1.95; 95% CI: 1.82, 2.09) dementia severity; and Black (aOR = 1.64; 95% CI: 1.47, 1.82), Hispanic ethnicity (aOR 1.13; 95% CI: 1.00, 1.28), frontotemporal (aOR 1.29; 95% CI: 1.12, 1.49) and Lewy body dementia (aOR 1.15; 95% CI: 1.02, 1.29) diagnosis type were associated with a higher odds of care-resistant behavior. Female sex (aOR 0.85; 95% CI: 0.80, 0.91) and higher education (aOR 0.9, 95% CI: 0.84, 0.97) were associated with lower odds of care-resistant behavior.

Interventions to manage care-resistant behaviors should consider sociocultural factors as well as type of dementia diagnosis to limit caregiver strain and burden.

Frontotemporal dementia, Lewy body dementia, and Black race were associated with a higher likelihood of exhibiting care-resistant behavior. Female sex and higher educational attainment were associated with a lower likelihood of exhibiting care-resistant behavior. Differences in specific presentations of care-resistant behaviors are less understood.