More than 40% of all assisted living communities do not provide mental health services, despite the high prevalence of dementia and depression among residents, according to a new report from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

Assisted living and other residential care communities increasingly are becoming the setting of care for older adults with Alzheimer’s disease and other dementias, according to the new report, which is based on data from the 2016 wave of the biennial National Study of Long-Term Care Providers.

In 2016, 41.9% of assisted living residents had diagnosed dementia, the authors said. Additionally, 30.9% of assisted living residents had depression, according to the report.

Mental health services are not provided at 49.4% of communities where more than 75% of residents have diagnosed dementia, 42.6% of communities where 25 to 75% of residents have diagnosed dementia and 44.5% of communities where less than 25% of residents have diagnosed dementia, the authors said.

In one fourth of residential care communities nationwide, more than 75% of residents had diagnosed Alzheimer’s disease or other dementias. Most of those communities (90.5%) were located in metropolitan areas compared with communities with lower percentages of residents with dementia.

Communities where more than 75% of residents had dementia were most likely to have four to 25 beds (77.5%) compared with 26 to 50 beds (11%) or more than 50 beds (11.6%).

Residents in communities where more than 75% of residents had dementia received an average of 33 more minutes of aide time and 10 more minutes of activities staff time compared with communities where fewer residents had dementia. But communities with the highest prevalence of dementia also had the highest prevalence of depression (38.7%).

By contrast, the rate of depression was 32.3% in communities where 25 to 75% of residents had dementia and was the lowest, 25.3%, in communities where dementia was diagnosed in less than 25% of residents.

Some organizational and staffing characteristics vary depending on the prevalence of residents with dementia, which may help inform providers, policymakers, researchers and consumer advocates about the differences among communities, the authors said.