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Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+).

Luppa M, Luck T, Matschinger H, König HH, Riedel-Heller SG - BMC Health Serv Res (2010)

Bottom Line: Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use.Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals.Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig, (Semmelweisstrasse 10), Leipzig, (04103), Germany. melanie.luppa@medizin.uni-leipzig.de

ABSTRACT

Background: In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA) among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA.

Methods: Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA.

Results: Of the overall sample, 7.8 percent of the non-demented elderly (n = 59) were admitted to nursing home (NH) during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use.

Conclusions: Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

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Related in: MedlinePlus

Sampling flowchart of the study.
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Figure 1: Sampling flowchart of the study.

Mentions: Of the overall sample of 1,692 subjects, 1,265 (74.8%) individuals were interviewed face-to-face at baseline, and for 113 study participants, a fully structured proxy interview with their relatives or caregivers was conducted. Therefore, information on 1,378 (81.4%) was gathered during the baseline wave between January 1997 and June 1998. Of the 1,378 subjects available for follow-up, 202 were already institutionalised at baseline, and 152 further individuals were diagnosed with dementia according to DSM-IV criteria [14]. As a result, 1,024 participants constitute the dementia-free population at risk (figure 1). These participants were requested to take part in up to five follow-up assessments conducted between July 1998 and April 2005, on average every 1.4 years.


Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+).

Luppa M, Luck T, Matschinger H, König HH, Riedel-Heller SG - BMC Health Serv Res (2010)

Sampling flowchart of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2909999&req=5

Figure 1: Sampling flowchart of the study.
Mentions: Of the overall sample of 1,692 subjects, 1,265 (74.8%) individuals were interviewed face-to-face at baseline, and for 113 study participants, a fully structured proxy interview with their relatives or caregivers was conducted. Therefore, information on 1,378 (81.4%) was gathered during the baseline wave between January 1997 and June 1998. Of the 1,378 subjects available for follow-up, 202 were already institutionalised at baseline, and 152 further individuals were diagnosed with dementia according to DSM-IV criteria [14]. As a result, 1,024 participants constitute the dementia-free population at risk (figure 1). These participants were requested to take part in up to five follow-up assessments conducted between July 1998 and April 2005, on average every 1.4 years.

Bottom Line: Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use.Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals.Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig, (Semmelweisstrasse 10), Leipzig, (04103), Germany. melanie.luppa@medizin.uni-leipzig.de

ABSTRACT

Background: In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA) among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA.

Methods: Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA.

Results: Of the overall sample, 7.8 percent of the non-demented elderly (n = 59) were admitted to nursing home (NH) during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use.

Conclusions: Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

Show MeSH
Related in: MedlinePlus