Impact of hip fracture, heart failure and weight loss on the risk of institutionalization of community‐dwelling patients with dementia

Harboun, M.; Dorenlot, Pascale; Cohen, Nadia H.; Steinhagen‐Thiessen, Elisabeth; Ankri, Joël

doi:10.1002/gps.2058

Cited by 14 publications

(19 citation statements)

References 23 publications

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“…These estimates are in accordance with previous studies showing a 2-3-fold increase in hip fracture risk among AD patients [1], [4], [6]–[8], [10]–[15], [21].…”

Section: Discussionsupporting

confidence: 93%

Incident Hip Fractures among Community Dwelling Persons with Alzheimer’s Disease in a Finnish Nationwide Register-Based Cohort

et al. 2013

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BackgroundPrevious cohort studies have shown that persons with Alzheimer’s disease (AD) have a higher risk of hip fractures but recent data from large representative cohorts is scarce.MethodsWe investigated the association between AD and prevalent and incident hip fractures in an exposure-matched cohort study conducted in Finland 2002–2009 (the Medication and Alzheimer’s disease in 2005 study; MEDALZ-2005). The study population included all community-dwelling persons with verified AD diagnosis in Finland on December 31, 2005 and one matched comparison person per AD case (N = 56,186, mean age 79.9 (SD 6.8) years, range 42–101 years). The diagnosis of AD was extracted from a special reimbursement register. Data on hip fractures during 2002–2009 was extracted from the Finnish National hospital discharge register. Analyses of incident hip fractures (n = 2,861) were restricted to years 2006–2009.ResultsPersons with AD were twice as likely to have previous hip fracture in 2005 (odds ratio, 95% confidence interval 2.00, 1.82–2.20) than matched aged population without AD. They were also more likely to experience incident hip fracture during the four-year follow-up (hazard ratio, 95% confidence interval 2.57, 2.32–2.84, adjusted for health status, psychotropic drug and bisphosphonate use). The AD-associated risk increase decreased linearly across age groups. Although people with AD had higher risk of hip fractures regardless of sex, the risk increase was larger in men than women.ConclusionFindings from our nationwide study are in line with previous studies showing that persons with AD, regardless of sex or age, have higher risk of hip fracture in comparison to general population. Although there was some suggestion of effect modification by age or sex, AD was consistently associated with doubling of the risk of incident hip fracture.

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“…These estimates are in accordance with previous studies showing a 2-3-fold increase in hip fracture risk among AD patients [1], [4], [6]–[8], [10]–[15], [21].…”

Section: Discussionsupporting

confidence: 93%

Incident Hip Fractures among Community Dwelling Persons with Alzheimer’s Disease in a Finnish Nationwide Register-Based Cohort

et al. 2013

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“…1). Other studies have found that, in addition to dementia, physical illness is an important predictor of institutionalization, too [91,92]. As the caregiver's health may change both due to caregiving and independently of it, it should be assigned not only to caregiving-related aspects, as it is done in the original model.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Institutionalization of Dementia Patients in Mild and Moderate Stages: A 4-Year Prospective Analysis

Eska

Graessel

Donath

et al. 2013

Dement Geriatr Cogn Disord Extra

106

105

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Background: Institutionalization is the most important milestone in the care of dementia patients. This study was aimed at identifying relevant predictors of institutionalization in a broad empirical context and interpreting them on the basis of the predictor model proposed by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Methods: At the start of this study, 357 patients with mild to moderate dementia were examined by their general practitioners, and a telephone interview was conducted with their caregivers. Four years later, the outcomes ‘institutionalization' and ‘death' were determined from health insurance data. Forty-one variables were examined for their predictive influence by univariate and multivariate Cox regression. Results: The risk of institutionalization increased significantly (p ≤ 0.05) with older ages of patients [hazard ratio (HR) = 1.05] and caregivers (HR = 1.03), a higher educational level of the caregiver (HR = 1.83), greater use of community health services (HR = 1.59), greater caregiver burden (HR = 1.02), and when the caregiver and patient lived apart (HR = 1.97). Conclusion: The results show that there is a multifactorial influence on institutionalization of dementia patients by sociodemographic, health-related, and psychological aspects as well as the care situation, thus validating the predictor model by Luppa et al. [Dement Geriatr Cogn Disord 2008;26:65-78]. Caregiver burden was found to be the strongest predictor accessible to interventions.

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“…One study 50 found that the presence of fracture in the three years before the diagnosis of dementia, the existence of acute congestive heart failure episodes and a body weight loss of over 5% over one year, were independently associated with the institutionalization of patients with dementia.…”

Section: Functional Recoverymentioning

confidence: 97%

The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care

Tarazona-Santabalbina

Doménech-Pascual

et al. 2014

Rev. Clin. Gerontol.

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2014). The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care. SummaryHip fracture is very common among older patients, who are characterized by increased co-morbidities, including cognitive impairment. These patients have an increased risk of falls and fractures, poorer functional recovery and lower survival both in hospital and 12 months after discharge. We review the survival and functional outcomes of older patients with cognitive impairment and hip fracture managed in orthogeriatric units, and highlight the gaps in our knowledge of the efficacy and efficiency of specific orthogeriatric programmes for such patients and the future research perspectives in this field.

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Impact of hip fracture, heart failure and weight loss on the risk of institutionalization of community‐dwelling patients with dementia

Cited by 14 publications

References 23 publications

Incident Hip Fractures among Community Dwelling Persons with Alzheimer’s Disease in a Finnish Nationwide Register-Based Cohort

Incident Hip Fractures among Community Dwelling Persons with Alzheimer’s Disease in a Finnish Nationwide Register-Based Cohort

Predictors of Institutionalization of Dementia Patients in Mild and Moderate Stages: A 4-Year Prospective Analysis

The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care

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