Solitary living in Alzheimer's disease over 3 years: association between cognitive and functional impairment and community-based services.
(2014) In Clinical Interventions in Aging 9. p.1951-1962- Abstract
- Introduction: Many individuals with Alzheimer’s disease (AD) live alone, and this figure is expected to increase. This study aimed to describe the cognitive and functional abilities of solitary-living AD patients, and the potential predictors of their usage of community-based services.
Methods: This 3-year, prospective, multicenter study included 1,021 participants with mild-to-moderate AD (Mini-Mental State Examination score, 10–26) treated with cholinesterase inhibitors (ChEI) in a routine clinical setting. At the baseline and every 6 months, patients were assessed using cognitive, instrumental and basic activities of daily living (ADL) scales, and service utilization was recorded. Logistic regression models were used to predict... (More) - Introduction: Many individuals with Alzheimer’s disease (AD) live alone, and this figure is expected to increase. This study aimed to describe the cognitive and functional abilities of solitary-living AD patients, and the potential predictors of their usage of community-based services.
Methods: This 3-year, prospective, multicenter study included 1,021 participants with mild-to-moderate AD (Mini-Mental State Examination score, 10–26) treated with cholinesterase inhibitors (ChEI) in a routine clinical setting. At the baseline and every 6 months, patients were assessed using cognitive, instrumental and basic activities of daily living (ADL) scales, and service utilization was recorded. Logistic regression models were used to predict the usage of community-based services.
Results: At the start of ChEI therapy (time of AD diagnosis), 355 individuals (35%) were living alone. They were mainly female, older, had more impaired basic ADL capacity, and a larger number of concomitant medications compared with those living with family. Regarding the solitary-living patients, lower instrumental ADL (IADL) ability and more medications were independent predictors of usage of home-help services, whereas more impaired IADL at baseline and faster IADL deterioration were predictors of nursing-home admission. For those living with family, older age, lower basic ADL, and a greater number of medications predicted home-help services, whereas a larger amount of home help predicted nursing-home placement. In addition, female sex was a risk factor for both the utilization of home-help services and nursing-home placement. Cognitive ability was not significantly associated with usage of community-based services.
Conclusions: A large number of AD patients, predominantly females, live alone with severe cognitive and functional impairment. The amount of home-help services used did not reflect cognitive severity, suggesting that home help did not meet the needs related to cognitive deterioration. Increased knowledge of how community-based services can better accommodate the care needs of solitary-living individuals with AD is essential. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4908791
- author
- Wattmo, Carina LU ; Londos, Elisabet LU and Minthon, Lennart LU
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Home-help services, Living status, Activities of daily living, Cognition, Nursing-home placement, Longitudinal study
- in
- Clinical Interventions in Aging
- volume
- 9
- pages
- 1951 - 1962
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- wos:000344921600001
- pmid:25484578
- scopus:84924793682
- pmid:25484578
- ISSN
- 1178-1998
- DOI
- 10.2147/CIA.S71709
- language
- English
- LU publication?
- yes
- id
- 626e38a7-72ef-45e2-a8bd-f99475d58ea9 (old id 4908791)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/25484578?dopt=Abstract
- date added to LUP
- 2016-04-01 10:53:13
- date last changed
- 2022-02-02 21:56:44
@article{626e38a7-72ef-45e2-a8bd-f99475d58ea9,
abstract = {{Introduction: Many individuals with Alzheimer’s disease (AD) live alone, and this figure is expected to increase. This study aimed to describe the cognitive and functional abilities of solitary-living AD patients, and the potential predictors of their usage of community-based services.<br/><br>
Methods: This 3-year, prospective, multicenter study included 1,021 participants with mild-to-moderate AD (Mini-Mental State Examination score, 10–26) treated with cholinesterase inhibitors (ChEI) in a routine clinical setting. At the baseline and every 6 months, patients were assessed using cognitive, instrumental and basic activities of daily living (ADL) scales, and service utilization was recorded. Logistic regression models were used to predict the usage of community-based services.<br/><br>
Results: At the start of ChEI therapy (time of AD diagnosis), 355 individuals (35%) were living alone. They were mainly female, older, had more impaired basic ADL capacity, and a larger number of concomitant medications compared with those living with family. Regarding the solitary-living patients, lower instrumental ADL (IADL) ability and more medications were independent predictors of usage of home-help services, whereas more impaired IADL at baseline and faster IADL deterioration were predictors of nursing-home admission. For those living with family, older age, lower basic ADL, and a greater number of medications predicted home-help services, whereas a larger amount of home help predicted nursing-home placement. In addition, female sex was a risk factor for both the utilization of home-help services and nursing-home placement. Cognitive ability was not significantly associated with usage of community-based services.<br/><br>
Conclusions: A large number of AD patients, predominantly females, live alone with severe cognitive and functional impairment. The amount of home-help services used did not reflect cognitive severity, suggesting that home help did not meet the needs related to cognitive deterioration. Increased knowledge of how community-based services can better accommodate the care needs of solitary-living individuals with AD is essential.}},
author = {{Wattmo, Carina and Londos, Elisabet and Minthon, Lennart}},
issn = {{1178-1998}},
keywords = {{Home-help services; Living status; Activities of daily living; Cognition; Nursing-home placement; Longitudinal study}},
language = {{eng}},
pages = {{1951--1962}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Clinical Interventions in Aging}},
title = {{Solitary living in Alzheimer's disease over 3 years: association between cognitive and functional impairment and community-based services.}},
url = {{https://lup.lub.lu.se/search/files/2208944/7851996.pdf}},
doi = {{10.2147/CIA.S71709}},
volume = {{9}},
year = {{2014}},
}