Background 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 institutionalisation for both subsamples.
Results Of 109 subjects with incident dementia who resided in private home at the time of the dementia diagnosis, 52 had become residents by the end of the study. Being widowed/divorced (compared to being married) was associated with a significantly shorter time until institutionalisation (univariate model: HR = 4.50, 95% CI 1.09 to 18.57). Of the dementia-free elderly individuals, 7.8% (n=59) were institutionalised 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.
Conclusions Being without a spouse seems to be a predictor of institutionalisation in incident dementia cases. For dementia-free individuals, the effect of severe physical or psychiatric diseases and living alone on NHA is considerably increased.