A Longitudinal Study of Transitions Between Informal and Formal Care in Alzheimer Disease Using Multistate Models in the European ICTUS Cohort
Abstract
Background We aimed to describe longitudinal patterns of care in community-dwelling European patients with Alzheimer disease (AD), and determine patient-, caregiver-, and country-related predictors of transitions across different care levels.Methods Two-year follow-up data from ICTUS cohort (1375 patients with AD, 12 countries) were analyzed using multistate Markov models to describe transitions across states of care and identify their predictors.Results Of the patients, 61.3% stayed in the same state during follow-up, and only 9.5% experienced ≥2 changes between states. Six-month transition probabilities were 11% for informal to formal care and 13% for formal to informal care (in the community). Older age, male gender, poorer cognitive and behavioral scores, and country of residence were associated with transitioning from informal to formal care, but only country of residence was associated with the reverse transition.Discussion Changes between different types of care were rare during follow-up, and country factors in particular influenced these transitions.
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Multi-state modeling can estimate Alzheimer's disease duration from stage progression and mortality rates without requiring very long follow-up.
“We estimated disease duration by applying a multi-state modeling approach, which has been previously used in AD research [22-25], and can offer an estimate of disease duration based on stage progression and mortality rates in the absence of very long follow-up duration.”
From Duration of preclinical, prodromal, and dementia stages of Alzheimer's disease in relation to age, sex, and <i>APOE</i> genotype (2019) · cites this paper as [24]
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- Authors
- Coley, N., Gallini, A., Garès, V., Gardette, V., Andrieu, S., Vellas, B., Reynish, E., Ousset, P. J., Andrieu, S., Burns, A., Pasquier, F., Frisoni, G., Salmon, E., Michel, J. P., Zekry, D. S., Boada, M., Dartigues, J. F., Olde-Rikkert, M. G. M., Rigaud, A. S., Winblad, B., Malick, A., Sinclair, A., Frölich, L., Scheltens, P., Ribera, C., Touchon, J., Robert, P., Salva, A., Waldmar, G., Bullock, R., Costa-Tsolaki, M., Rodriguez, G., Spiru, L., Jones, R. W., Stiens, G., Stoppe, G., Eriksdotter Jönhagen, M., Cherubini, A., Lage, P. M., Gomez-Isla, T., Camus, V., Agüera-Morales, E., Lopez, F., Andrieu, S., Savy, S., Cantet, C., Coley, N., Andrieu, S., Savy, S., Cantet, C., & Coley, N.
- Affiliations
- Université Toulouse III - Paul Sabatier (FR)
- The University of Sydney (AU)
- ORCID
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 16
- Issue
- 12
- Pages
- 1104.e1-1104.e7
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2180164556
- Cited by
- 20
- References
- 35
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 1 · 2016: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- Alzheimer's disease, informal care, formal care, care transitions, community-dwelling patients, caregivers, country of residence, cognitive impairment, behavioral symptoms
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Europe, Female, Patient Care, Humans, Longitudinal Studies, Male, Patient Transfer, Multivariate Analysis, Caregivers
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