Predictors of Institutionalization of Dementia Patients in Mild and Moderate Stages: A 4-Year Prospective Analysis
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Background: Institutionalization is the most important milestone in the care of dementia patients. This study was aimed at identifying relevant predictors of institutionalization in a broad empirical context and interpreting them on the basis of the predictor model proposed by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Methods: At the start of this study, 357 patients with mild to moderate dementia were examined by their general practitioners, and a telephone interview was conducted with their caregivers. Four years later, the outcomes ‘institutionalization' and ‘death' were determined from health insurance data. Forty-one variables were examined for their predictive influence by univariate and multivariate Cox regression. Results: The risk of institutionalization increased significantly (p ≤ 0.05) with older ages of patients [hazard ratio (HR) = 1.05] and caregivers (HR = 1.03), a higher educational level of the caregiver (HR = 1.83), greater use of community health services (HR = 1.59), greater caregiver burden (HR = 1.02), and when the caregiver and patient lived apart (HR = 1.97). Conclusion: The results show that there is a multifactorial influence on institutionalization of dementia patients by sociodemographic, health-related, and psychological aspects as well as the care situation, thus validating the predictor model by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Caregiver burden was found to be the strongest predictor accessible to interventions.
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Worsening psychological and physical health in caregivers can adversely impact the individual with dementia, for example by increasing the likelihood of institutionalization of the person with dementia.
“In addition, worsening psychological and physical health in caregivers can adversely impact the individual with dementia—for example, they increase the likelihood of institutionalization of the person with dementia, which is associated with decreased psychological and physical health and increased mortality in individuals with dementia [11], [12], [13], [14].”
From A novel two-day intervention reduces stress in caregivers of persons with dementia (2018) · cites this paper as [12]
The Results (Multivariate Analysis; page not provided) identify higher subjective caregiver burden as a predictor of institutionalization, supporting a link between caregiver distress and placement risk. The Discussion (Conceptual Framework; page not provided) proposes caregiver physical health as a factor to include in a predictive model, but does not establish that worsening physical health increases that risk. The study reports an association with burden, not that deteriorating caregiver health causes institutionalization. (LLM, conf=0.87)
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Profile of BPSD in Elderly People with Dementia at UPTD Griya Werdha Jambangan Surabaya
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To Assess Caregiver Burden of Patients with Dementia: Its Sociodemographic and Clinical Correlates
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- Authors
- Eska, K., Graessel, E., Donath, C., Schwarzkopf, L., Lauterberg, J., & Holle, R.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Helmholtz Munich (DE)
- Institute for Quality and Efficiency in Health Care (DE)
- Corresponding author
- Eska, Kathrin
- Venue
- Dementia and Geriatric Cognitive Disorders Extra
- Publisher
- S. Karger AG
- Published
- 2013-11-01
- Volume
- 3
- Issue
- 1
- Pages
- 426-445
- ISSN
- 1664-5464 (ISSN-L)
- PMC
- PMC3843910
- OpenAlex
- W2035225376
- Cited by
- 119
- References
- 96
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 10 · 2023: 8 · 2022: 8 · 2021: 25 · 2020: 7 · 2019: 11 · 2018: 9 · 2017: 11 · 2016: 9 · 2015: 5 · 2014: 6
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Dementia and Geriatric Cognitive Disorders Extra (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Site cant be reached (submittedVersion, cc-by-nc)
- OPUS FAU (Kooperativer Bibliotheksverbund Berlin-Brandenburg (KOBV), on behalf of the Universitätsbibliothek Erlangen-Nürnberg) (submittedVersion, cc-by-nc-nd)
- Funders
- Pfizer
- Deutsche Forschungsgemeinschaft
- Eisai
- 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
- dementia, institutionalization, predictors of institutionalization, mild to moderate dementia, caregiver burden, community-based care, risk factors
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