Predictors of Institutionalization of Dementia Patients in Mild and Moderate Stages: A 4-Year Prospective Analysis
Open Access
- 1 November 2013
- journal article
- research article
- Published by S. Karger AG in Dementia and Geriatric Cognitive Disorders Extra
- Vol. 3 (1), 426-445
- https://doi.org/10.1159/000355079
Abstract
Background: Institutionalization is the most important milestone in the care of dementia patients. This study was aimed at identifying relevant predictors of institutionalization in a broad empirical context and interpreting them on the basis of the predictor model proposed by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Methods: At the start of this study, 357 patients with mild to moderate dementia were examined by their general practitioners, and a telephone interview was conducted with their caregivers. Four years later, the outcomes ‘institutionalization' and ‘death' were determined from health insurance data. Forty-one variables were examined for their predictive influence by univariate and multivariate Cox regression. Results: The risk of institutionalization increased significantly (p ≤ 0.05) with older ages of patients [hazard ratio (HR) = 1.05] and caregivers (HR = 1.03), a higher educational level of the caregiver (HR = 1.83), greater use of community health services (HR = 1.59), greater caregiver burden (HR = 1.02), and when the caregiver and patient lived apart (HR = 1.97). Conclusion: The results show that there is a multifactorial influence on institutionalization of dementia patients by sociodemographic, health-related, and psychological aspects as well as the care situation, thus validating the predictor model by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Caregiver burden was found to be the strongest predictor accessible to interventions.Keywords
This publication has 95 references indexed in Scilit:
- Long-term care use and socio-economic status in Belgium: a survival analysis using health care insurance dataArchives of Public Health, 2013
- Effect of Chronic Dementia Caregiving and Major Transitions in the Caregiving Situation on Kidney FunctionPsychosomatic Medicine, 2012
- Cardiometabolic Effects in Caregivers of Nursing Home Placement and Death of Their Spouse with Alzheimer's DiseaseJournal of the American Geriatrics Society, 2011
- Neuropsychiatric Symptoms and the Risk of Institutionalization and Death: The Aging, Demographics, and Memory StudyJournal of the American Geriatrics Society, 2011
- Do Trajectories of At-Home Dementia Caregiving Account for Burden After Nursing Home Placement? A Growth Curve AnalysisSocial Work in Health Care, 2010
- Counsellors contact dementia caregivers - predictors of utilisation in a longitudinal studyBMC Geriatrics, 2010
- Consequences of Aggressive Behavior in Patients With DementiaThe Journal of Neuropsychiatry and Clinical Neurosciences, 2010
- Unwanted incidents during transition of geriatric patients from hospital to home: a prospective observational studyBMC Health Services Research, 2010
- Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer diseaseJournal of Neurology, Neurosurgery & Psychiatry, 2009
- Influence of cognitive impairment on the institutionalisation rate 3 years after a strokeJournal of Neurology, Neurosurgery & Psychiatry, 2007