Determinants of time to institutionalisation and related healthcare and societal costs in a community-based cohort of patients with Alzheimer’s disease dementia

Belger, Mark; Haro, Josep María; Reed, Catherine; Happich, Michael; Argimón, Josep M.; Bruno, Giuseppe; Dodel, Richard; Jones, Roy; Vellas, Bruno; Wimo, Anders

doi:10.1007/s10198-018-1001-3

Cited by 31 publications

(49 citation statements)

References 54 publications

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“…Previous studies with similar findings also hypothesized that highly dependent people are perhaps well supported by informal caregivers and community-based services, which may delay institutionalization. 4,10 Finally, we found that people who were prescribed dementia med-…”

Section: F I G U R E 3 Cox Survival Curves Of Time Until Death Withinmentioning

confidence: 90%

“…Studies varied considerably in design, sample selection, sample size, follow‐up time, and consequently, in estimations with median time ranging from 2.5 to 7.3 years. There was a lack of methodological strength in a majority of studies, such as use of small and selected samples, relatively short follow‐up time, and selection of prevalent dementia cases with unclear disease onset 4‐10 …”

Section: Introductionmentioning

confidence: 99%

“…There was a lack of methodological strength in a majority of studies, such as use of small and selected samples, relatively short follow-up time, and selection of prevalent dementia cases with unclear disease onset. [4][5][6][7][8][9][10] With regard to the prognosis of survival, the average duration from diagnosis until death varied substantially across studies, ranging from 1.1 to 8.5 years. 11,12 Again, most studies used prevalent cases from study entry and included small or selected samples.…”

mentioning

confidence: 99%

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Time from diagnosis to institutionalization and death in people with dementia

Joling

Janssen

Francké

et al. 2020

Alzheimer's & Dementia

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Introduction Reliable estimates of time from diagnosis until institutionalization and death in people with dementia from routine nationally representative databases are lacking. Methods We selected 9230 people with dementia and 24,624 matched controls from family physicians’ electronic records linked with national administrative databases to analyze time until institutionalization and death and associated factors. Results Median time from recorded diagnosis until institutionalization and until death for people with dementia was 3.9 and 5.0 years, respectively, which was considerably shorter than for controls. Once institutionalized, median time to death was longer for persons with dementia (2.5 years) than for controls (1.2 years). Older age and receiving home care were the strongest predictors of shorter time until institutionalization and death in people with dementia. Gender, cohabitation, migration status, frailty, polypharmacy, and dementia medication were other significant factors. Discussion The estimates could help to inform patients, their families, and policymakers about probable trajectories.

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Section: F I G U R E 3 Cox Survival Curves Of Time Until Death Withinmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Time from diagnosis to institutionalization and death in people with dementia

Joling

Janssen

Francké

et al. 2020

Alzheimer's & Dementia

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“…The research also clearly emphasizes that institutional care for dementia patients is much more expensive than home care [34,35]. Therefore, in order to delay institutional care, many countries support family carers and invest in community care services [36,37].…”

Section: Costs Of Care In Dementiamentioning

confidence: 99%

Dementia as a contemporary challenge for providing care for the aging populations

Klich-Rączka¹

2019

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Dementia occurs with a frequency of 10-12% in the entire geriatric population and 33-50% in people over 90 years of age. The most common cause of dementia are: Alzheimer's disease, rarely vascular dementia, dementia with Lewy bodies, frontotemporal dementia and Parkinson's disease with dementia. There are no medicaments to prevent dementia and effectively treat it. The treatment only slows the progression and improves the quality of life of the patient and caregiver. Taking care of a patient with dementia burdens the caregiver. As the disease progresses, care time extends even to the entire day. Over 90% of caregivers in Poland are family carers. Over 90% of patients stay in their own home until death. The cost of care is high and increases with the duration of the disease. In the case of agitated patients, the cost is higher. Institutional care is more expensive than home care. In Poland, there are no good system solutions in care for a dementia patient. Caregivers do not receive proper support from the government and subordinate units.

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“…As the number of people with dementia increases globally [1], dementia has become a public health priority [2,3]. Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care [4][5][6]. Neuropsychiatric symptoms contribute to the overall costs of dementia care, both in the community [7,8] and in care homes [9].…”

Section: Introductionmentioning

confidence: 99%

Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings

Nakanishi

Niimura

Ziylan

et al. 2020

Journal of Alzheimer's Disease Reports

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Background: There are no studies on how the same psychosocial dementia care program is adapted to both in-home and residential care settings. Objective: To evaluate the time investment required by professionals to implement a psychosocial dementia care program to manage neuropsychiatric symptoms. Methods: A prospective observational study design was used. The program consisted of 1) a one-day training course, 2) three interdisciplinary discussion meetings in five months, and 3) a web-based tool for the continued assessment of neuropsychiatric symptoms. Care professionals implemented the intervention in in-home (19 in-home care management agencies and 14 multiple in-home service providers) and residential care settings (19 group homes and eight nursing homes) in Japan from October 2019 to February 2020. The level of neuropsychiatric symptoms for the participants was evaluated using the Neuropsychiatric Inventory (NPI: 0–144). The time investment was reported by participating professionals. A total of 125 persons with dementia were included at baseline. Results: Neuropsychiatric symptoms were significantly decreased at the final follow-up in all types of providers (Cohen’s drm = 0.44–0.61). The mean (SD) time required for the five-month implementation was 417.9 (219.8) minutes. There was a mean (SD) decrease of 8.6 (14.0) points in the total NPI score among the 103 persons with completed interventions. The time investment was significantly lower in in-home care management agencies than in group homes, and lower in follow-ups than at baseline assessment. Conclusion: The program implementation may incur a substantial time investment regardless of setting. An additional benefit scheme to reward the time investment would be helpful to encourage implementation until the follow-ups.

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Determinants of time to institutionalisation and related healthcare and societal costs in a community-based cohort of patients with Alzheimer’s disease dementia

Abstract: Total societal costs and total patient costs rise steeply as community-dwelling patients with AD dementia approach institutionalisation.

Cited by 31 publications

References 54 publications

Time from diagnosis to institutionalization and death in people with dementia

Time from diagnosis to institutionalization and death in people with dementia

Dementia as a contemporary challenge for providing care for the aging populations

Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings

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