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Cholinesterase inhibitors do not alter the length of stay in nursing homes among patients with Alzheimer's disease : A prospective, observational study of factors affecting survival time from admission to death

Wattmo, Carina LU ; Londos, Elisabet LU and Minthon, Lennart LU (2016) In BMC Neurology 16(1).
Abstract

Background: The survival time in nursing homes (NHs) in Alzheimer's disease (AD) might be affected by sociodemographic/clinical characteristics, rate of disease progression, and use of specific medications and community-based services. Whether different aspects of cholinesterase inhibitor (ChEI) therapy modify time spent in NHs is unclear. Therefore, we examined the relationship between these potential predictors and survival time in NHs. Methods: This prospective, multicenter study of ChEI treatment in clinical practice included 220 deceased patients clinically diagnosed with mild-to-moderate AD who were admitted to NHs during the study. Cognitive and activities of daily living (ADL) performance, ChEI dose, and amount of services... (More)

Background: The survival time in nursing homes (NHs) in Alzheimer's disease (AD) might be affected by sociodemographic/clinical characteristics, rate of disease progression, and use of specific medications and community-based services. Whether different aspects of cholinesterase inhibitor (ChEI) therapy modify time spent in NHs is unclear. Therefore, we examined the relationship between these potential predictors and survival time in NHs. Methods: This prospective, multicenter study of ChEI treatment in clinical practice included 220 deceased patients clinically diagnosed with mild-to-moderate AD who were admitted to NHs during the study. Cognitive and activities of daily living (ADL) performance, ChEI dose, and amount of services used/week were evaluated every 6 months over 3 years. Dates of nursing-home placement (NHP) and death were recorded. Variables that determined survival time in NHs were analyzed using general linear models. Results: The mean survival time in NHs was 4.06 years (men, 2.78 years; women, 4.53 years; P < 0.001). The multivariate model showed that a shorter stay in NHs was associated with the interaction term male living with a family member, use of antihypertensive/cardiac therapy or anxiolytics/sedatives/hypnotics, and worse basic ADL at NHP, but not with age or cognitive and instrumental ADL capacities. Conclusions: Increased community-based care did not reduce the survival time in NHs among individuals with AD. Men living with family spent significantly less time in NHs compared with the corresponding women, which suggests that the situation of female spouses of AD patients may need attention and possibly support. There was no indication that different aspects of ChEI therapy, e.g., drug type, dose, or duration, alter survival time in NHs.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Activities of daily living, Alzheimer's disease, Cholinesterase inhibitors, Cognition, Community-based services, Longitudinal study, Predictors, Sex, Survival time in nursing homes
in
BMC Neurology
volume
16
issue
1
publisher
BioMed Central
external identifiers
  • scopus:84984706656
  • wos:000384486600001
ISSN
1471-2377
DOI
10.1186/s12883-016-0675-3
language
English
LU publication?
yes
id
03f70275-8ba1-4d24-a30c-a64d6a11b387
date added to LUP
2016-09-21 10:04:50
date last changed
2017-01-01 08:34:33
@article{03f70275-8ba1-4d24-a30c-a64d6a11b387,
  abstract     = {<p>Background: The survival time in nursing homes (NHs) in Alzheimer's disease (AD) might be affected by sociodemographic/clinical characteristics, rate of disease progression, and use of specific medications and community-based services. Whether different aspects of cholinesterase inhibitor (ChEI) therapy modify time spent in NHs is unclear. Therefore, we examined the relationship between these potential predictors and survival time in NHs. Methods: This prospective, multicenter study of ChEI treatment in clinical practice included 220 deceased patients clinically diagnosed with mild-to-moderate AD who were admitted to NHs during the study. Cognitive and activities of daily living (ADL) performance, ChEI dose, and amount of services used/week were evaluated every 6 months over 3 years. Dates of nursing-home placement (NHP) and death were recorded. Variables that determined survival time in NHs were analyzed using general linear models. Results: The mean survival time in NHs was 4.06 years (men, 2.78 years; women, 4.53 years; P &lt; 0.001). The multivariate model showed that a shorter stay in NHs was associated with the interaction term male living with a family member, use of antihypertensive/cardiac therapy or anxiolytics/sedatives/hypnotics, and worse basic ADL at NHP, but not with age or cognitive and instrumental ADL capacities. Conclusions: Increased community-based care did not reduce the survival time in NHs among individuals with AD. Men living with family spent significantly less time in NHs compared with the corresponding women, which suggests that the situation of female spouses of AD patients may need attention and possibly support. There was no indication that different aspects of ChEI therapy, e.g., drug type, dose, or duration, alter survival time in NHs.</p>},
  articleno    = {156},
  author       = {Wattmo, Carina and Londos, Elisabet and Minthon, Lennart},
  issn         = {1471-2377},
  keyword      = {Activities of daily living,Alzheimer's disease,Cholinesterase inhibitors,Cognition,Community-based services,Longitudinal study,Predictors,Sex,Survival time in nursing homes},
  language     = {eng},
  month        = {08},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Neurology},
  title        = {Cholinesterase inhibitors do not alter the length of stay in nursing homes among patients with Alzheimer's disease : A prospective, observational study of factors affecting survival time from admission to death},
  url          = {http://dx.doi.org/10.1186/s12883-016-0675-3},
  volume       = {16},
  year         = {2016},
}