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Predictors of institutionalization among home-dwelling older Finnish people: a 22-year follow-up study

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Abstract

Background

Identification of predictive factors on institutionalization provides the basis for the development and application of preadmission assessment. There is a lack of evidence for predictors of institutionalization for older people.

Aims

To examine the effect of predictive factors on institutionalization in home-dwelling 70-year-old people.

Methods

The data were collected in 1991 by the clinical examinations, a postal questionnaire, and an interview from the residents of Turku, Finland, born in 1920 (n = 1032). Institutionalization was defined as entry into a nursing home or sheltered housing at any time during a 22-year follow-up.

Results

A rate of institutionalization was 22.0%. In multivariable Cox regression analysis, impaired cognitive function (MMSE 18–26) (hazard ratio 1.71, confidence interval 1.24–2.36) and low BMI (<25 kg/m2) (compared to both BMI of 25–29.9 and that of ≥30, respectively, 1.88, 1.32–2.67, and 1.66, 1.05–2.60), having several falls during the previous year (2.50, 1.28–4.90).

Conclusions

We conclude that impaired cognitive function, low BMI, and frequent falling predicted institutionalization during the 22-year follow-up. To reduce or postpone institutionalization, interventions should target risk factors, such as frailty, physical limitations, and falling. In addition, community-based services according to the needs and functional ability of the home-dwelling older people should be developed.

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Acknowledgements

The study was financially supported by EVO funding of the city of Turku/Welfare Division, Red Feather Campaign of the Nordic Lions Club, and King Gustav V and Queen Victoria Foundation.

Author information

Authors and Affiliations

  1. Unit of Family Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, 20014, Turku, Finland

    Marika Salminen

  2. City of Turku, Welfare division, Yliopistonkatu 30, Turku, Finland

    Marika Salminen

  3. Department of Geriatrics, Faculty of Medicine, University of Turku, Kunnallissairaalantie 20, Turku, Finland

    Jenni Vire, Laura Viikari, Aapo Lehtonen & Matti Viitanen

  4. Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland

    Tero Vahlberg

  5. Statcon Ltd., Savenvalajankatu 3 B 25, Turku, Finland

    Hannu Isoaho

  6. Division of clinical geriatrics Karolinska Institute, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden

    Matti Viitanen

  7. Department of Nursing Science, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, Turku, Finland

    Seija Arve & Sini Eloranta

  8. Hospital District of Southwest Finland, Kiinanmyllynkatu 4–8, Turku, Finland

    Sini Eloranta

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  1. Marika Salminen
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Correspondence to Marika Salminen.

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Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Salminen, M., Vire, J., Viikari, L. et al. Predictors of institutionalization among home-dwelling older Finnish people: a 22-year follow-up study. Aging Clin Exp Res 29, 499–505 (2017). https://doi.org/10.1007/s40520-016-0722-3

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  • DOI: https://doi.org/10.1007/s40520-016-0722-3

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