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Cited by 297Dementia and Cognitive Impairment ResearchGeriatric Care and Nursing HomesPalliative Care and End-of-Life Issues

Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia

O'Donnell, Brian F., Drachman, David A., Barnes, Heather J., Peterson, Karen E., Swearer, Joan M., Lew, Robert A.·1992·Journal of Geriatric Psychiatry and Neurology
DOI 10.1177/002383099200500108
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Abstract

Factors predicting the early institutionalization of demented patients were studied in 143 outpatients using univariate and multivariate life-table methods. Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characteristics, and type of caregiver. After follow-up of 19 ± 12 months, 51 patients had been institutionalized. Increased global severity of dementia, the presence of troublesome and disruptive behaviors, and incontinence increased the likelihood of institutionalization. The best predictors of institutionalization were paranoia, aggressive behavior, and incontinence. Neither individual patient characteristics (age, education, and gender) nor caregiver relationship to the patient (male spouse, female spouse, and male or female child) influenced institutionalization. Since troublesome behavioral disorders are potentially treatable aspects of dementia leading to institutionalization, their management should be a major focus of therapy in dementia. ( J Geriatr Psychiatry Neurol 1992;5:45–52).

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Authors
O'Donnell, B. F., Drachman, D. A., Barnes, H. J., Peterson, K. E., Swearer, J. M., & Lew, R. A.
Affiliations
  • Department of Neurology (Drs Drachman, O'Donnell, and Swearer and Ms Barnes and Peterson) and the Biostatistics and Applied Mathematics Service (Dr Lew) at the University of Massachusetts Medical Center, Worcester MA, and the Brockton VA Medical Center (Dr O'Donnell), Brockton, MA.
  • University of Massachusetts Chan Medical School (US)
ORCID
Lew, Robert A.
Venue
Journal of Geriatric Psychiatry and Neurology
Publisher
SAGE Publications
Published
1992-01
Volume
5
Issue
1
Pages
45-52
ISSN
  • 0891-9887 (ISSN-L)
  • 1552-5708
DOI
10.1177/002383099200500108
OpenAlex
W1998675635
Cited by
297
References
28
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 7 · 2017: 3 · 2016: 11 · 2015: 6 · 2014: 8 · 2013: 3 · 2012: 14
FWCI
3.13
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Geriatric Psychiatry and Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
Funders
National Institute on Aging (2-P50-0AG05134)
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, incontinence, behavioral disorders, paranoia, aggression, functional disability, caregiver type, prognostic factors, dementia severity, outpatients
MeSH terms
Activities of Daily Living, Aged, Aggression, Alzheimer Disease, Fecal Incontinence, Female, Follow-Up Studies, Humans, Institutionalization, Male, Massachusetts, Social Behavior, Urinary Incontinence, Life Tables, Caregivers

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