Time until Institutionalization in Incident Dementia Cases – Results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)

Abstract

Background: Information on the time until institutionalization and its predictors in demented subjects has so far been based on studies with selected samples or prevalent dementia cases. Thus, the aim of the study is to analyze the time until institutionalization and associated patient-related factors in incident dementia cases. Methods: Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA 75+), a population-based study of individuals aged 75 years and older. Kaplan-Meier survival analysis was used to determine the time until institutionalization. Factors associated with time until institutionalization were analyzed using Cox proportional hazards models. Results: One hundred and nine subjects with incident dementia who resided in a private home setting at the time of the dementia diagnosis were identified. Fifty-two (47.7%) of these subjects had become residents of a nursing home by the end of the study. The median time until institutionalization was 1,005 days (95% CI = 808–1,202). Being widowed/divorced (compared to being married) was associated with a significantly shorter time until institutionalization (univariate model: HR = 4.50, 95% CI = 1.09–18.57). Conclusion: Being without a spouse seems to be an important factor for a shorter time until institutionalization in incident dementia cases. Tailored interventions for these subjects at risk are required.

Prediction of Institutionalisation in Dementia

“…Most of the studies recruited samples from Alzheimer's disease (AD) diagnostic centres or memory clinics (MC) as well as samples of patients receiving community-based long-term care (CLTC). Others analysed data files of health care providers, and three studies were related to population-based samples [14][15][16] . Half of the studies included samples of patients and their caregivers, others exclusively included patients or caregivers, and a few obtained information on the patients from the caregivers ( table 1 ).…”

Health Among the Elderly in Germany. New Evidence on Disease, Disability and Care Need

“…As expected, we found that median time until LTC became necessary was shorter than the median time until institutionalization (H1). Luck et al (2008) reported a median time of 2.8 years until a nursing home placement was made. In our analysis, the median amount of time that elapsed between the diagnosis and the need for LTC arose was 21 months, or 1.75 years.…”

“…Both studies used Cox modeling, which does not allow for an analysis of the distribution of the risk of institutionalization over time. But the study by Luck et al (2008) showed that 33% of all nursing home placements within six years occurred in the first six months after diagnosis. The risk of institutionalization seems to be particularly high in the first few months.…”

Menschen mit Demenz in der primärärztlichen Versorgung

“…[11]. Bekannte Risikofaktoren, wie Depression, oder auch bekannte protektive Faktoren, wie eine stimulierende Arbeitsumwelt ("enriched environment"), müssen demnach differenzierter betrachtet werden als bis dato üblich [12,13].…”