A longitudinal study of risk factors for community-based home help services in Alzheimer's disease: the influence of cholinesterase inhibitor therapy
(2013) In Clinical Interventions in Aging 8. p.329-339- Abstract
- Background: To investigate the long-term effects of cholinesterase inhibitor (ChEI) therapy and the influence of sociodemographic and clinical factors on the use of community-based home help services (HHS) by patients with Alzheimer's disease (AD). Methods: This 3-year, prospective, multicenter study included 880 AD patients treated with donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every 6 months, the patients were assessed with several rating scales, including the Mini-Mental State Examination, Instrumental Activities of Daily Living (IADL), and Physical Self-Maintenance Scale. Doses of ChEI and amounts of HHS per week were recorded. Cox regression models were used to predict the time to HHS, and... (More)
- Background: To investigate the long-term effects of cholinesterase inhibitor (ChEI) therapy and the influence of sociodemographic and clinical factors on the use of community-based home help services (HHS) by patients with Alzheimer's disease (AD). Methods: This 3-year, prospective, multicenter study included 880 AD patients treated with donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every 6 months, the patients were assessed with several rating scales, including the Mini-Mental State Examination, Instrumental Activities of Daily Living (IADL), and Physical Self-Maintenance Scale. Doses of ChEI and amounts of HHS per week were recorded. Cox regression models were used to predict the time to HHS, and multiple linear regression was used to predict the volume of HHS used. Results: During the study, 332 patients (38%) used HHS. Factors that both postponed HHS use and predicted lower amounts of HHS were higher doses of ChEIs, better IADL ability, and living with family. Men, younger individuals, and those with a slower IADL decline showed a longer time to HHS, whereas female sex, a lower cognitive status, or more medications at baseline predicted fewer hours of HHS. Conclusions: Higher doses of ChEI might reduce the use of HHS, possibly reducing the costs of community-based care. Female spouses provide more informal care than do male spouses, so the likelihood of using HHS is greater among women with AD. The "silent group" of more cognitively impaired and frail elderly AD patients receives less HHS, which might precipitate institutionalization. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3651158
- author
- Wattmo, Carina LU ; Paulsson, Elisabeth ; Minthon, Lennart LU and Londos, Elisabet LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cognition, activities of daily living, treatment effect, gender, predictors
- in
- Clinical Interventions in Aging
- volume
- 8
- pages
- 329 - 339
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- wos:000316450600001
- scopus:84875360556
- pmid:23682212
- ISSN
- 1178-1998
- DOI
- 10.2147/CIA.S40087
- language
- English
- LU publication?
- yes
- id
- 37de0465-fe9e-4d22-a155-c398bbb15b50 (old id 3651158)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23682212
- date added to LUP
- 2016-04-01 10:53:34
- date last changed
- 2022-04-28 02:40:33
@article{37de0465-fe9e-4d22-a155-c398bbb15b50,
abstract = {{Background: To investigate the long-term effects of cholinesterase inhibitor (ChEI) therapy and the influence of sociodemographic and clinical factors on the use of community-based home help services (HHS) by patients with Alzheimer's disease (AD). Methods: This 3-year, prospective, multicenter study included 880 AD patients treated with donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every 6 months, the patients were assessed with several rating scales, including the Mini-Mental State Examination, Instrumental Activities of Daily Living (IADL), and Physical Self-Maintenance Scale. Doses of ChEI and amounts of HHS per week were recorded. Cox regression models were used to predict the time to HHS, and multiple linear regression was used to predict the volume of HHS used. Results: During the study, 332 patients (38%) used HHS. Factors that both postponed HHS use and predicted lower amounts of HHS were higher doses of ChEIs, better IADL ability, and living with family. Men, younger individuals, and those with a slower IADL decline showed a longer time to HHS, whereas female sex, a lower cognitive status, or more medications at baseline predicted fewer hours of HHS. Conclusions: Higher doses of ChEI might reduce the use of HHS, possibly reducing the costs of community-based care. Female spouses provide more informal care than do male spouses, so the likelihood of using HHS is greater among women with AD. The "silent group" of more cognitively impaired and frail elderly AD patients receives less HHS, which might precipitate institutionalization.}},
author = {{Wattmo, Carina and Paulsson, Elisabeth and Minthon, Lennart and Londos, Elisabet}},
issn = {{1178-1998}},
keywords = {{cognition; activities of daily living; treatment effect; gender; predictors}},
language = {{eng}},
pages = {{329--339}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Clinical Interventions in Aging}},
title = {{A longitudinal study of risk factors for community-based home help services in Alzheimer's disease: the influence of cholinesterase inhibitor therapy}},
url = {{https://lup.lub.lu.se/search/files/2210888/4017550.pdf}},
doi = {{10.2147/CIA.S40087}},
volume = {{8}},
year = {{2013}},
}