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Predictors of institutionalization in people with dementia: a survey linked with administrative data

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Abstract

Background

For people with dementia, moving into a nursing home is usually considered at some point in time. Currently available information on predictors of institutionalization is often based on small sample sizes, not taking competing risks into account, and with inconclusive results for sex.

Aims

We aimed to carry out an analysis stratified by sex and using a competing risk approach.

Methods

We carried out an analysis of a survey linked with administrative data including 652 people with dementia, aged 60 years and older. The follow-up was up to 4.5 years. We used the cumulative incidence function for examining time until institutionalization and survival time and the sub-distribution hazard model for estimating hazard ratios.

Results

The participants were on average 81 years old, about 51% were female. At the end of the follow-up, 282 people had been institutionalized and 273 had died. The regression models show that the risk of institutionalization is higher in women than in men and when cared for by a care service in comparison to an informal caregiver. Inhibiting factors are Care Level (II, III) and positive evaluation of caregiving by caregivers. Stratified analysis by sex revealed that the risk of institutionalization in men is influenced by their relationship to their caregiver, in women by duration of care at baseline.

Discussion

Sex seems to play a role in predicting institutionalization.

Conclusion

Future research should focus on stratified analysis by sex. Knowing the predictors of institutionalization for men and women could influence long-term care management remarkably.

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Acknowledgements

We thank the German health insurance fund BARMER GEK for providing the data analysed in our study and for their support while conducting the survey. The survey was conducted in the context of a project funded by the BARMER GEK.

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Authors and Affiliations

  1. University of Bremen, SOCIUM, Mary-Somerville Street 5, 28359, Bremen, Germany

    Rebecca Runte

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  1. Rebecca Runte
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Correspondence to Rebecca Runte.

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There is no conflict of interest.

Informed consent

By returning the questionnaire participants gave their consent.

Research including human participants

All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Appendix

Appendix

See Table 3.

Table 3 Characteristics of participants and non-participants
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Runte, R. Predictors of institutionalization in people with dementia: a survey linked with administrative data. Aging Clin Exp Res 30, 35–43 (2018). https://doi.org/10.1007/s40520-017-0737-4

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  • DOI: https://doi.org/10.1007/s40520-017-0737-4

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