Predictors of institutionalization in Latinos with dementia.

Abstract

The present study identified predictors of time to institutionalization among elderly Latinos suffering from dementia, and determined how these predictors varied when compared to Caucasians and African-Americans. The sample included 324 Latino, 701 African-American, and 7,100 Caucasian dementia patients and their caregivers recruited from eight catchment regions in the U.S. and were assessed over a 3-year period. Potential predictors considered in the event history analyses included context of care and indicators of care recipient cognitive and functional status, caregiver stress and depression, and caregiving resources. Cox proportional hazards models revealed that various indicators of sociodemographic context, caregiver well-being, and community-based service utilization influenced time to institutionalization among Latinos. Cross-ethnic/racial comparisons also identified statistical variations in site, living arrangement, intensity of informal care provision, caregiver depression, and adult day service use across the Latino, Caucasian, and African-American samples when predicting time to nursing home placement. The findings emphasize the need to explore time to institutionalization across racial and ethnic contexts, and suggest future variables to consider when analyzing nursing home placement in diverse situations.