Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+)
Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+)
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DOI：
10.1186/1472-6963-10-186
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发表时间：
2010-06-29
影响因子：
2.8
通讯作者：
Riedel-Heller, Steffi G.
中科院分区：
文献类型：
--
作者：
Luppa, Melanie;Luck, Tobias;Riedel-Heller, Steffi G.
背景：在过去的几十年里，大量以社区为基础的研究（主要包括痴呆病例）调查了老年人养老院入院（NHA）的预测因素。然而，没有一项研究分析了在NHA之前没有患痴呆症的个体的NHA预测因素。方法：数据来源于莱比锡老年人纵向研究，这是一项以75岁及以上人群为基础的研究。1024名无痴呆的老年人平均每1.4年接受6次采访。获得社会人口学、临床和心理测量变量。Kaplan-Meier估计用于确定到达NHA的平均时间。采用Cox比例风险回归检验长期NHA的预测因素。结果：在整个样本中，7.8%的非痴呆老年人（n = 59）在研究期间被送入养老院（NH）。在无痴呆的样本中，产生NHA的平均时间是7.6年。与较短的NHA时间相关的特征是年龄增加、独居、功能和认知障碍、重度抑郁症、中风、心肌梗死、专家就诊次数少和有偿家庭佣工的使用。结论：严重的身体或精神疾病和独居对无痴呆个体的NHA有显著影响。研究结果提供了二级预防的潜力，以避免或延迟这些老年人的NHA。对机构化预测因素的进一步调查是有必要的，以促进对这一重要群体导致NHA的过程的理解。
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.