Abstract
BackgroundIn 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.MethodsData 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.ResultsOf 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.ConclusionsSevere 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.
Highlights
In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA) among elderly people
Demographic changes will lead to a considerable increase in the numbers and proportion of elderly in most developed countries after the year 2010 [1]. This demographic trend associated with a higher incidence of chronic conditions and a rapid advance in medical technology may cause a steep rise in the number of institutionalised elderly people [1]
Previous longitudinal research examining predictors of NHA in old age with multivariate analyses has been conducted in population-based community samples [5] and in samples limited to individuals with dementia [4]
Summary
In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA) among elderly people. Demographic changes will lead to a considerable increase in the numbers and proportion of elderly in most developed countries after the year 2010 [1]. This demographic trend associated with a higher incidence of chronic conditions and a rapid advance in medical technology may cause a steep rise in the number of institutionalised elderly people [1]. Previous longitudinal research examining predictors of NHA in old age with multivariate analyses has been conducted in population-based community samples [5] and in samples limited to individuals with dementia [4].
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