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.
(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.
(Less)
- author
- Wattmo, Carina LU ; Londos, Elisabet LU and Minthon, Lennart LU
- organization
- publishing date
- 2016-08-31
- 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
- article number
- 156
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:27581368
- wos:000384486600001
- scopus:84984706656
- 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
- 2024-10-05 01:57:00
@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 < 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>}},
author = {{Wattmo, Carina and Londos, Elisabet and Minthon, Lennart}},
issn = {{1471-2377}},
keywords = {{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 (BMC)}},
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}},
doi = {{10.1186/s12883-016-0675-3}},
volume = {{16}},
year = {{2016}},
}