P1-222 Predictors of institutionalisation in individuals with and without dementia: results from the Leipzig longitudinal study of the aged (LEILA75+)

Abstract

Background/Objectives: In previous decades a substantial number of studies examined predictors of nursing home admission (NHA) among elderly individuals with and without dementia. As the first, this study aims to analyse predictors of NHA of incident dementia cases and of individuals without developing dementia before NHA. Methods: Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA 75+), a population-based study of individuals aged 75 years and older. Socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over six waves. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term institutionalization for both subsamples. Results: 109 subjects with incident dementia who resided in a private home setting at the time of the dementia diagnosis were identified. Fifty-two (47.7%) of these subjects had become residents of a nursing home by the end of the study. The median time until institutionalization was 1,005 days (95% CI=808-1,202). Being widowed/divorced (compared to being married) was associated with a significantly shorter time until institutionalization (univariate model: HR=4.50, 95% CI=1.09-18.57). Of the dementia-free elderly individuals, 7.8% (n=59) were institutionalized during the study period. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits, and paid home helper use. Discussion/Conclusions: Being without a spouse seems to be a predictor of institutionalization in incident dementia cases. Tailored interventions for these subjects at risk are required. Although factors leading to NHA among individuals not developing dementia before NHA are similar to those driving the entry in population-based studies including dementia cases, the effect of severe physical or psychiatric diseases and living alone on NHA is considerably increased for dementia-free individuals.