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Cited by 120Dementia and Cognitive Impairment ResearchGeriatric Care and Nursing HomesPalliative Care and End-of-Life Issues

The DOI matches its Crossref record; 96 of the 96 references it cites were found in a registry or an index.

Predictors of Institutionalization of Dementia Patients in Mild and Moderate Stages: A 4-Year Prospective Analysis

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Eska, Kathrin, Graessel, Elmar, Donath, Carolin, Schwarzkopf, Larissa, Lauterberg, Joerg, Holle, Rolf·2013·Dementia and Geriatric Cognitive Disorders Extra
DOI 10.1159/000355079PMC PMC3843910
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Abstract

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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Fig. 1 Capital letters represent variables in the model by Luppa et al. [49]. Variables in our study are in parentheses (…), 39 variables are shown (the adjustment variables study arm B and C are excluded). Significant predictors from our multivariate analysis are given in bold. Some variables cannot be assigned to the predictor model by Luppa et al. [49]: EQ-5D (P), Incalzi Comorbidity Index, antidementia drugs, psychopharmaceutical drugs, and nonpharmacological therapy. Black boxes contain suggestions for modifications of the model by Luppa et al. [49]. Arrows indicate shifts within the modifications. P = Patient; CG = caregiver.
Fig. 1 Capital letters represent variables in the model by Luppa et al. [49]. Variables in our study are in parentheses (…), 39 variables are shown (the adjustment variables study arm B and C are excluded). Significant predictors from our multivariate analysis are given in bold. Some variables cannot be assigned to the predictor model by Luppa et al. [49]: EQ-5D (P), Incalzi Comorbidity Index, antidementia drugs, psychopharmaceutical drugs, and nonpharmacological therapy. Black boxes contain suggestions for modifications of the model by Luppa et al. [49]. Arrows indicate shifts within the modifications. P = Patient; CG = caregiver.CC BY-NC · PubMed Central

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Metadata

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
ORCID
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)
DOI
10.1159/000355079
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
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 › Medicine › Geriatrics and Gerontology › 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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