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Cited by 26Geriatric Care and Nursing HomesAging, Health, and DisabilityDementia and Cognitive Impairment Research

Diabetes-associated factors as predictors of nursing home admission and costs in the elderly across Europe

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Rodríguez-Sánchez, Beatriz, Angelini, Viola, Feenstra, Talitha, Alessie, Rob J.M.·2017·Journal of the American Medical Directors Association
DOI 10.1016/j.jamda.2016.09.011
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Abstract

Objective To identify the main factors associated with the use of nursing home facilities and to calculate their costs among older people with diabetes in Europe. Methods The sample included 48,464 individuals aged 50 years and older in 12 European countries participating in the Survey of Health, Aging, and Retirement in Europe study from 2004 to 2010. Cost data were obtained from the Organization for Economic Cooperation and Development and the World Bank. Logit regressions were used to assess the impact of diabetes, comorbidities, and functional status on the frequency of nursing home admission. Etiologic fractions were calculated to obtain the nursing home costs attributable to diabetes and its clinical and functional complications. Results Diabetes is a predictor for institutionalization. When adjusted for clinical and functional complications, impairment of physical function [mild: odds ratio (OR) 3.27; 95% confidence interval (CI) 2.60-4.19; moderate: OR 8.48, 95% CI 6.02-13.09; severe: OR 12.53, 95% CI 8.03-19.98] and cognition (OR 2.00, 95% CI 1.60-2.68), as well as stroke (OR 2.08, 95% CI 1.61-2.80) showed the strongest association with increased risk of institutionalization. Moreover, this relationship between diabetes, function, and cost was age-dependent, increasing as people get older. Total average nursing home costs incurred by patients with diabetes reached nearly US $13/capita, ranging between countries from US $61 to $0.5. Diabetes-related complications accounted for one-third of these costs (US $4) and, of these, 78% resulted from functional impairment. Conclusions Diabetes is associated with higher risk of institutionalization even after adjusting for complications. Among them, functional impairment explains the major part of the association between diabetes and nursing home admission and leads to increasing costs.

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  • Older adults with diabetes are at higher risk of cognitive decline and institutionalization than older adults without diabetes.

    “Older adults with diabetes are at higher risk of cognitive decline and institutionalization than older adults without diabetes (17–19).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [19]

    The Discussion and Conclusions report that diabetes predicts nursing home admission among older adults, supporting the institutionalization part. The paper treats cognitive impairment as a predictor of institutionalization, but does not establish that older adults with diabetes have a higher risk of cognitive decline than those without diabetes. Page numbers are not available in our copy. (LLM, conf=0.88)

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Authors
Rodríguez-Sánchez, B., Angelini, V., Feenstra, T., & Alessie, R. J. M.
Affiliations
  • University of Groningen (NL)
  • University Medical Center Groningen (NL)
Corresponding author
Rodríguez-Sánchez, Beatriz
ORCID
Venue
Journal of the American Medical Directors Association
Publisher
Elsevier BV
Published
2017-01
Volume
18
Issue
1
Pages
74-82
ISSN
1525-8610 (ISSN-L)
DOI
10.1016/j.jamda.2016.09.011
OpenAlex
W2546600543
Cited by
26
References
2
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 2 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 1 · 2017: 2
FWCI
4.97
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Medical Directors Association (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Funders
  • Seventh Framework Programme (211909, 227822, 261982)
  • Sixth Framework Programme (CIT4-CT-2006-028812, CIT5-CT-2005-028857, RII-CT-2006-062193)
  • Fifth Framework Programme (QLK6-CT-2001-00360)
  • European Commission
  • Bundesministerium für Bildung und Forschung
  • National Institute on Aging (IAG_BSR06-11, OGHA_04-064, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, U01_AG09740-13S2, Y1-AG-4553-01)
Topics
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
diabetes mellitus, nursing home admission, institutionalization, nursing home costs, older adults, physical function impairment, cognitive impairment, stroke, comorbidities, diabetes complications, population attributable fraction
MeSH terms
Aged, Aged, 80 and over, Diabetes Mellitus, Europe, Female, Humans, Male, Middle Aged, Nursing Homes, Patient Admission, Surveys and Questionnaires

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