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Published in: Social Psychiatry and Psychiatric Epidemiology 2/2012

01-02-2012 | Original Paper

Age-related predictors of institutionalization: results of the German study on ageing, cognition and dementia in primary care patients (AgeCoDe)

Authors: Melanie Luppa, Steffi G. Riedel-Heller, Tobias Luck, Birgitt Wiese, Hendrik van den Bussche, Franziska Haller, Melanie Sauder, Edelgard Mösch, Michael Pentzek, Anja Wollny, Marion Eisele, Thomas Zimmermann, Hans-Helmut König, Wolfgang Maier, Horst Bickel, Jochen Werle, Siegfried Weyerer, For the AgeCoDe study group

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2012

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Abstract

Background

In the last decades, many community-based studies have addressed predictors of nursing home placement (NHP) among the elderly. So far, predictors have not been analyzed separately for different age groups.

Methods

For a German GP-sample of 3,208 subjects aged 75 years and older, socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over three waves. Logistic regression models determined predictors of NHP for total sample and for two different age groups. A CART analysis identified factors discriminating best between institutionalized and non-institutionalized individuals.

Results

Of the overall sample, 4.7% of the sample (n = 150) was institutionalized during the study period. Baseline characteristics associated with a higher risk of NHP for the total sample were age, living without spouse, cognitive and functional impairment and depression. In the CART analysis, age was the major discriminator at the first level (at age 81). In subgroup regression analyses, for the younger elderly (age 75–81) being single as well as cognitive and functional impairment increased the risk of NHP; in the advanced elderly (age 82+) being widowed and subjective memory impairment were significant predictors for NHP, and cognitive and functional impairment became non-significant as predictors of NHP.

Conclusions

Predictors of NHP may differ in old age groups. The fact that many predictors show inconsistent results as predictors of NHP in the international literature may be attributed to the lack of differentiation in age groups.
Literature
1.
go back to reference Kinsella K, Velkoff VA (2001) An aging world: 2001. International Population Reports. Washington DC: US Bureau of Census, US Government Printing Office Kinsella K, Velkoff VA (2001) An aging world: 2001. International Population Reports. Washington DC: US Bureau of Census, US Government Printing Office
2.
go back to reference Channon A, Matthews Z, Van Lerberghe W (2006) Will there be enough people to care? Notes on the workforce implications of demographic change 2005–2050? Background paper prepared for The world health report 2006: working together for health. World Health Organization Channon A, Matthews Z, Van Lerberghe W (2006) Will there be enough people to care? Notes on the workforce implications of demographic change 2005–2050? Background paper prepared for The world health report 2006: working together for health. World Health Organization
3.
go back to reference Wancata J, Musalek M, Alexandrowicz R, Krautgartner M (2003) Number of dementia sufferers in Europe between the years 2000 and 2050. Eur Psychiatry 18:306–313PubMedCrossRef Wancata J, Musalek M, Alexandrowicz R, Krautgartner M (2003) Number of dementia sufferers in Europe between the years 2000 and 2050. Eur Psychiatry 18:306–313PubMedCrossRef
4.
go back to reference Federal Statistical Office (2007) Pflegestatistik 2005—Pflege im Rahmen der Pflegeversicherung—Deutschlandergebnisse. Statistisches Bundesamt, Wiesbaden Federal Statistical Office (2007) Pflegestatistik 2005—Pflege im Rahmen der Pflegeversicherung—Deutschlandergebnisse. Statistisches Bundesamt, Wiesbaden
5.
go back to reference Gaugler JE, Duval S, Anderson KA, Kane RL (2007) Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatr 7:13PubMedCrossRef Gaugler JE, Duval S, Anderson KA, Kane RL (2007) Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatr 7:13PubMedCrossRef
6.
go back to reference Luppa M, Luck T, Brähler E, König H-H, Riedel-Heller SG (2008) Prediction of institutionalisation in dementia—a systematic review. Dement Geriatr Cogn Disord 26:65–78PubMedCrossRef Luppa M, Luck T, Brähler E, König H-H, Riedel-Heller SG (2008) Prediction of institutionalisation in dementia—a systematic review. Dement Geriatr Cogn Disord 26:65–78PubMedCrossRef
7.
go back to reference Luppa M, Luck T, Weyerer S, König H-H, Brähler E, Riedel-Heller SG (2010) Prediction of institutionalisation in the elderly. A systematic review. Age Ageing 39:31–38PubMedCrossRef Luppa M, Luck T, Weyerer S, König H-H, Brähler E, Riedel-Heller SG (2010) Prediction of institutionalisation in the elderly. A systematic review. Age Ageing 39:31–38PubMedCrossRef
8.
go back to reference Wingard DL, Jones DW, Kaplan RM (1987) Institutional care utilization by the elderly: a critical review. Gerontologist 27:156–163PubMedCrossRef Wingard DL, Jones DW, Kaplan RM (1987) Institutional care utilization by the elderly: a critical review. Gerontologist 27:156–163PubMedCrossRef
9.
go back to reference Chenier MC (1987) Review and analysis of caregiver burden and nursing home placement. Geriatr Nurs 18:121–126CrossRef Chenier MC (1987) Review and analysis of caregiver burden and nursing home placement. Geriatr Nurs 18:121–126CrossRef
10.
go back to reference Zaudig M, Hiller W (1996) SIDAM-Handbuch Strukturiertes Interview für die Diagnose einer Demenz vom Alzheimer Typ, der Multiinfarkt- (oder vaskulären) Demenz und Demenzen anderer Ätiologie nach DSM-III-R, DSM-IV, ICD-10. Verlag Hans Huber, Bern Zaudig M, Hiller W (1996) SIDAM-Handbuch Strukturiertes Interview für die Diagnose einer Demenz vom Alzheimer Typ, der Multiinfarkt- (oder vaskulären) Demenz und Demenzen anderer Ätiologie nach DSM-III-R, DSM-IV, ICD-10. Verlag Hans Huber, Bern
11.
go back to reference Folstein MF, Folstein SE, McHugh PR (1965) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRef Folstein MF, Folstein SE, McHugh PR (1965) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRef
12.
go back to reference Luck T, Zaudig M, Wiese B, Riedel-Heller SG (2007) SIDAM: age- and education-specific reference values for the cognitive test section according to the new CASMIN Educational Classification. Z Gerontopsychol Psychiatr 20:31–38 Luck T, Zaudig M, Wiese B, Riedel-Heller SG (2007) SIDAM: age- and education-specific reference values for the cognitive test section according to the new CASMIN Educational Classification. Z Gerontopsychol Psychiatr 20:31–38
13.
go back to reference Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C (1989) The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 39:1159–1165PubMed Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C (1989) The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 39:1159–1165PubMed
14.
go back to reference Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMedCrossRef Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMedCrossRef
15.
go back to reference Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. Clinical Gerontologist 5:165–173CrossRef Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. Clinical Gerontologist 5:165–173CrossRef
16.
go back to reference Gauggel S, Birkner B (1999) Validity and reliability of a German version of the Geriatric Depression Scale (GDS). Z Klin Psychol Forschung Praxis 28:18–27CrossRef Gauggel S, Birkner B (1999) Validity and reliability of a German version of the Geriatric Depression Scale (GDS). Z Klin Psychol Forschung Praxis 28:18–27CrossRef
17.
go back to reference Breiman L, Friedman JH, Olshen RA, Stone CJ (1984) Classification and regression trees. Wadsworth, Belmont Breiman L, Friedman JH, Olshen RA, Stone CJ (1984) Classification and regression trees. Wadsworth, Belmont
18.
go back to reference Brauns H, Steinmann S (1999) Educational reform in France, West-Germany and the United Kingdom. ZUMA-Nachr 44:7–44 Brauns H, Steinmann S (1999) Educational reform in France, West-Germany and the United Kingdom. ZUMA-Nachr 44:7–44
19.
go back to reference Harris Y (2007) Depression as a risk factor for nursing home admission among older individuals. J Am Med Dir Assoc 8:14–20PubMedCrossRef Harris Y (2007) Depression as a risk factor for nursing home admission among older individuals. J Am Med Dir Assoc 8:14–20PubMedCrossRef
20.
go back to reference Aguero-Torres H, von Strauss E, Viitanen M, Winblad B, Fratiglioni L (2004) Institutionalization in the elderly: the role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study. J Clin Epidemiol 54:795–801CrossRef Aguero-Torres H, von Strauss E, Viitanen M, Winblad B, Fratiglioni L (2004) Institutionalization in the elderly: the role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study. J Clin Epidemiol 54:795–801CrossRef
21.
go back to reference Woo J, Ho SC, Yu AL, Lau J (2000) An estimate of long-term care needs and identification of risk factors for institutionalization among Hong Kong Chinese aged 70 years and over. J Gerontol A Biol Sci Med Sci 55:M64–M69PubMedCrossRef Woo J, Ho SC, Yu AL, Lau J (2000) An estimate of long-term care needs and identification of risk factors for institutionalization among Hong Kong Chinese aged 70 years and over. J Gerontol A Biol Sci Med Sci 55:M64–M69PubMedCrossRef
22.
go back to reference Miller EA, Weissert WG (2000) Predicting elderly people’s risk for nursing home placement, hospitalization, functional impairment, and mortality: a synthesis. Med Care Res Rev 57:259–297PubMedCrossRef Miller EA, Weissert WG (2000) Predicting elderly people’s risk for nursing home placement, hospitalization, functional impairment, and mortality: a synthesis. Med Care Res Rev 57:259–297PubMedCrossRef
23.
go back to reference Gaugler JE, Yu F, Krichbaum K, Wyman JF (2009) Predictors of nursing home admission for persons with dementia. Medical Care 47:191–198PubMedCrossRef Gaugler JE, Yu F, Krichbaum K, Wyman JF (2009) Predictors of nursing home admission for persons with dementia. Medical Care 47:191–198PubMedCrossRef
24.
go back to reference Riedel-Heller SG, Busse A, Aurich C, Matschinger H, Angermeyer MC (2001) Prevalence of dementia according to DSM-III-R and ICD-10: results of the Leipzig Longitudinal Study of the Aged (LEILA75+) Part 1. Br J Psychiatry 179:250–254PubMedCrossRef Riedel-Heller SG, Busse A, Aurich C, Matschinger H, Angermeyer MC (2001) Prevalence of dementia according to DSM-III-R and ICD-10: results of the Leipzig Longitudinal Study of the Aged (LEILA75+) Part 1. Br J Psychiatry 179:250–254PubMedCrossRef
25.
go back to reference Jagger C, Gillies C, Moscone F, Cambois E, van Oyen H, Nusselder W, Robine JM (2008) Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. Lancet 372:2124–2131PubMedCrossRef Jagger C, Gillies C, Moscone F, Cambois E, van Oyen H, Nusselder W, Robine JM (2008) Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. Lancet 372:2124–2131PubMedCrossRef
Metadata
Title
Age-related predictors of institutionalization: results of the German study on ageing, cognition and dementia in primary care patients (AgeCoDe)
Authors
Melanie Luppa
Steffi G. Riedel-Heller
Tobias Luck
Birgitt Wiese
Hendrik van den Bussche
Franziska Haller
Melanie Sauder
Edelgard Mösch
Michael Pentzek
Anja Wollny
Marion Eisele
Thomas Zimmermann
Hans-Helmut König
Wolfgang Maier
Horst Bickel
Jochen Werle
Siegfried Weyerer
For the AgeCoDe study group
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 2/2012
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-010-0333-9

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