Premium
Living Alone with Alzheimer's Disease and the Risk of Adverse Outcomes: Results from the Plan de Soin et d'Aide dans la maladie d'Alzheimer Study
Author(s) -
Soto Maria,
Andrieu Sandrine,
Gares Valérie,
Cesari Matteo,
GilletteGuyonnet Sophie,
Cantet Christelle,
Vellas Bruno,
Nourhashémi Fati
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13347
Subject(s) - medicine , institutionalisation , hazard ratio , dementia , activities of daily living , gerontology , population , disease , alzheimer's disease , intervention (counseling) , randomization , confidence interval , randomized controlled trial , physical therapy , psychiatry , environmental health
Objectives To examine whether living alone predicted hospitalizations, nursing home admission, weight loss, and death in individuals with mild to moderate Alzheimer's disease ( AD ) over 2 years of follow‐up. Design Data are from the Plan de Soin et d'Aide dans la maladie d'Alzheimer study, a 24‐month trial with a cluster randomization of memory clinics in two arms: a multidomain intervention and usual care. Setting Memory clinics in France (N = 50). Participants Community‐dwelling individuals with AD with a Mini‐Mental State Examination score between 12 and 26 and an identified caregiver. Measurements A neurogeriatric evaluation was conducted twice a year in the intervention group and annually in the control group. Hospitalizations, nursing home admission, weight loss, and death occurring during the past year were recorded. Information on sociodemographic characteristics, clinical conditions, therapy, and physical and cognitive status was recorded. Results At inclusion, 348 (30.8%) of the 1,131 participants lived alone. Living alone did not increase the risk of mortality or weight loss in individuals with mild to moderate AD , but significant associations with risk of hospitalization (hazard ratio ( HR ) = 1.33, 95% confidence interval ( CI ) = 1.01–1.74) and institutionalization ( HR = 2.53, 95% CI = 1.84–3.47) were reported. A protective effect of physical function on institutionalization and mortality was found. Conclusion These results might support clinicians in making decisions about institutionalization of individuals with AD living alone or improving home health care, such as increasing screening and managing functional impairment in this complex population.