Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study

Salminen, Marika; Laine, Jonna; Vahlberg, Tero; Viikari, Paula; Wuorela, Maarit; Viitanen, Matti; Viikari, Laura

doi:10.1007/s41999-020-00338-7

Cited by 21 publications

(20 citation statements)

References 28 publications

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“…Routine laboratory parameters do not predict dementia or cognitive impairment which are considered the most common causes for institutionalization [28][29][30][31][32]. Other predictive factors for institutionalization, impairing an older person's ability to live independently, are increased falls, decreasing body mass index [28,29] and functional impairment and disabilities, especially when combined with cognitive impairment [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

A practical laboratory index to predict institutionalization and mortality – an 18-year population-based follow-up study

et al. 2021

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Background Previously, several indexes based on a large number of clinical and laboratory tests to predict mortality and frailty have been produced. However, there is still a need for an easily applicable screening tool for every-day clinical practice. Methods A prospective study with 10- and 18-year follow-ups. Fourteen common laboratory tests were combined to an index. Cox regression model was used to analyse the association of the laboratory index with institutionalization and mortality. Results The mean age of the participants (n = 1153) was 73.6 (SD 6.8, range 64.0–100.0) years. Altogether, 151 (14.8%) and 305 (29.9%) subjects were institutionalized and 422 (36.6%) and 806 (69.9%) subjects deceased during the 10- and 18-year follow-ups, respectively. Higher LI (laboratory index) scores predicted increased mortality. Mortality rates increased as LI scores increased both in unadjusted and in age- and gender-adjusted models during both follow-ups. The LI did not significantly predict institutionalization either during the 10- or 18-year follow-ups. Conclusions A practical index based on routine laboratory tests can be used to predict mortality among older people. An LI could be automatically counted from routine laboratory results and thus an easily applicable screening instrument in clinical settings.

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Section: Discussionmentioning

confidence: 99%

A practical laboratory index to predict institutionalization and mortality – an 18-year population-based follow-up study

et al. 2021

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“…In Finland, as in other Western countries, the population is ageing and the proportion of inhabitants aged 65 years or older is growing [1]. The proportion of dementia as a cause of death has increased during recent years [2] and dementia is also the leading cause of institutionalization in the elderly [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Other factors associated with a higher risk of institutionalization include higher age, living alone, low socioeconomic status, use of home care, low number of specialist visits, low self-rated health (SRH), low body mass index (BMI), cognitive and functional impairment including walking difficulties and falls, and several chronic conditions, such as Parkinson's disease, mood disorders, stroke and multimorbidity [4][5][6][7][8][9][10][11][12]. Among the oldest old women (> 90 years), Parkinson's disease, depression, hip fracture, and multimorbidity, in addition to dementia, predict a higher risk of institutionalization [13].…”

Section: Introductionmentioning

confidence: 99%

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Chronic conditions and multimorbidity associated with institutionalization among Finnish community-dwelling older people: an 18-year population-based follow-up study

Viljanen

Salminen

Irjala³

et al. 2021

Eur Geriatr Med

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Purpose The ageing population is increasingly multimorbid. This challenges health care and elderly services as multimorbidity is associated with institutionalization. Especially dementia increases with age and is the main risk factor for institutionalization. The aim of this study was to assess the association of chronic conditions and multimorbidity with institutionalization in home-dwelling older people, with and without dementia. Methods In this prospective study with 18-year follow-up, the data on participants’ chronic conditions were gathered at the baseline examination, and of conditions acquired during the follow-up period from the municipality’s electronic patient record system and national registers. Only participants institutionalized or deceased by the end of the follow-up period were included in this study. Different cut-off-points for multimorbidity were analyzed. Cox regression model was used in the analyses. Death was used as a competing factor. Results The mean age of the participants (n = 820) was 74.7 years (64.0‒97.0). During the follow-up, 328 (40%) were institutionalized. Dementia, mood disorders, neurological disorders, and multimorbidity defined as five or more chronic conditions were associated with a higher risk of institutionalization in all the participants. In people without dementia, mood disorders and neurological disorders increased the risk of institutionalization. Conclusion Having dementia, mood or neurological disorder and/or five or more chronic conditions were associated with a higher risk of institutionalization. These risk factors should be recognized when providing and targeting care and support for older people still living at home.

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“…In 2019, 4.9 million (8.9%) older U.S. adults were living below the poverty threshold, with a disproportionately high representation of Hispanic and Black older adults [3,4]. Healthcare costs or those from an unexpected illness, and physical and mental health deterioration can result in a downward spiral in independent functioning, eventually leading to unwanted institutionalization [5]. "Aging in Place" is an increasingly popular concept that re ects the overwhelming preference of older adults to live out their lives in their own homes as opposed to a structured, typically healthcare focused (and almost universally more expensive) institutionalized setting [6].…”

Section: Introductionmentioning

confidence: 99%

Feasibility Trial of an Integrated Treatment "Activate for Life" for Physical and Mental Well-being in Older Adults

Hernandez‐Tejada

Nagel

Madisetti

et al. 2021

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This paper describes feasibility and patient satisfaction for an integrated treatment to address multiple health outcomes in a sample of older adults living in a low-income independent residence facility and their own homes in the community. Specifically, 30 older adults were offered the opportunity to participate in a feasibility study of different components of Activate for Life treatment targeting balance and physical strength (Otago Exercise Program), breathing retraining (Gentle Yoga and Yogic Breathing), and mental health (Behavioral Activation for Depression). Three treatment combinations were compared in a randomized repeated measures design to determine if adding components to the existing Otago program were feasible and if this affected patient satisfaction. Arm1: the Otago strength and balance program alone (n = 10); Arm 2: Otago + Gentle Yoga and Yogic Breathing (n = 10); and Arm 3: Otago + Gentle Yoga and Yogic Breathing + Behavioral Activation (we named this combination ‘Activate for Life’ n = 10). Dependent measures included recruitment rate, session completion characteristics, and satisfaction with the program. Overall, study and treatment components proved feasible, and participants reported high satisfaction with all 3 Arms.

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Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study

Cited by 21 publications

References 28 publications

A practical laboratory index to predict institutionalization and mortality – an 18-year population-based follow-up study

A practical laboratory index to predict institutionalization and mortality – an 18-year population-based follow-up study

Chronic conditions and multimorbidity associated with institutionalization among Finnish community-dwelling older people: an 18-year population-based follow-up study

Feasibility Trial of an Integrated Treatment "Activate for Life" for Physical and Mental Well-being in Older Adults

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