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Predictors of entering 24‐h care for people with Alzheimer's disease: results from the LASER‐AD study
Author(s) -
Habermann Stephanie,
Cooper Claudia,
Katona Cornelius,
Livingston Gill
Publication year - 2009
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2259
Subject(s) - hazard ratio , dementia , medicine , proportional hazards model , psychological intervention , disease , longitudinal study , gerontology , cohort study , cohort , confidence interval , psychology , psychiatry , pathology
Objectives Many studies have investigated predictors of people with dementia entering 24‐h care but this is the first to consider a comprehensive range of carer and care recipient (CR) characteristics derived from a systematic review, in a longitudinal cohort study followed up for several years. Methods We interviewed 224 people with Alzheimer's disease (AD) and their carers, recruited to be representative in terms of their severity, sex and living situation as part of the LASER‐AD study; and determined whether they entered 24‐h care in the subsequent 4.5 years. We tested a comprehensive range of characteristics derived from a systematic review, and used Cox proportional hazard regression to determine whether they independently predicted entering 24‐h care. Results The main independent predictors of shorter time to enter 24‐h care were the patient being: more cognitively or functionally impaired (hazard ratio (HR) = 1.09; 95% CI = 1.06–1.12) and (HR = 1.04 95% CI = 1.03–1.05), having a paid versus a family carer (HR = 2.22; 95% CI = 1.39–3.57), the carer being less educated (HR = 1.43; 95% CI = 1.12–1.83) and spending less hours caring (HR = 1.01; 95% CI = 1.00–1.01). Conclusion As having a family carer who spent more time caring (taking into account illness severity) delayed entry to 24‐h care, future research should investigate how to enable carers to provide this. Other interventions to improve patients' impairment may not only have benefits for patients' health but also allow them to remain longer at home. This financial benefit could more than offset the treatment cost. Copyright © 2009 John Wiley & Sons, Ltd.