Nursing home admission in elderly subjects with dementia: predictive factors and future challenges.

Détails

ID Serval
serval:BIB_2A7996408FF1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Nursing home admission in elderly subjects with dementia: predictive factors and future challenges.
Périodique
Journal of the American Medical Directors Association
Auteur(s)
Dramé M., Lang P.O., Jolly D., Narbey D., Mahmoudi R., Lanièce I., Somme D., Gauvain J.B., Heitz D., Voisin T., de Wazières B., Gonthier R., Ankri J., Saint-Jean O., Jeandel C., Couturier P., Blanchard F., Novella J.L.
ISSN
1538-9375 (Electronic)
ISSN-L
1525-8610
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
13
Numéro
1
Pages
83.e17-83.e20
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
OBJECTIVES: The aim of this study was to identify factors predictive of nursing home admission (NHA) over a period of 1 year among elderly subjects with dementia.
METHODS: The study population was drawn from the SAFES cohort that was formed within a national research program into the recruitment of emergency departments in 9 teaching hospitals. Subjects were to have been hospitalized in a medical ward in the same hospital as the emergency department to which they were initially admitted. Subjects who experienced NHA before emergency department admission were excluded. Those with a confirmed diagnosis of dementia were considered in the present analysis. NHA has been defined as the incident admission into either a nursing home or other long term care facility within the follow-up period. Data obtained from a Comprehensive Geriatric Assessment were used in a Cox model to predict 1-year NHA.
RESULTS: The 425 subjects of the study were 86 ± 6 years old, and were mainly women (63%). NHA rate was 40% (n = 172). Four factors were identified to increase NHA risk: age 85 or older (hazard ratio [HR] = 1.5; 95% confidence interval [CI] = 1.1-2.1), inability to use the toilet (HR = 2.5; 95% CI = 1.5-4.2), balance disorders (HR = 1.5; 95% CI = 1.1-2.1), and living alone (HR = 1.5; 95% CI = 1.1-2.1). Three factors decreased this risk significantly: inability to transfer (HR = 0.5; 95% CI = 0.3-0.8), increased number of children (HR = 0.88; 95% CI = 0.96-0.99), and increased initial Mini-Mental State Examination score (HR = 0.97; 95% CI = 0.8-0.9).
CONCLUSION: NHA determinants in dementia are strongly linked to the patient's own characteristics but also to his or her physical or social environment. Interventions should target both members of the dyad "patient-caregiver" because both are affected by the disease.
Mots-clé
Aged, 80 and over, Cohort Studies, Dementia, Female, Forecasting, France, Humans, Interviews as Topic, Male, Nursing Homes, Patient Admission/trends, Proportional Hazards Models
Pubmed
Web of science
Création de la notice
15/04/2015 8:25
Dernière modification de la notice
20/08/2019 13:10
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