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Age-related predictors of institutionalization: results of the German study on ageing, cognition and dementia in primary care patients (AgeCoDe)

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Abstract

Background

In the last decades, many community-based studies have addressed predictors of nursing home placement (NHP) among the elderly. So far, predictors have not been analyzed separately for different age groups.

Methods

For a German GP-sample of 3,208 subjects aged 75 years and older, socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over three waves. Logistic regression models determined predictors of NHP for total sample and for two different age groups. A CART analysis identified factors discriminating best between institutionalized and non-institutionalized individuals.

Results

Of the overall sample, 4.7% of the sample (n = 150) was institutionalized during the study period. Baseline characteristics associated with a higher risk of NHP for the total sample were age, living without spouse, cognitive and functional impairment and depression. In the CART analysis, age was the major discriminator at the first level (at age 81). In subgroup regression analyses, for the younger elderly (age 75–81) being single as well as cognitive and functional impairment increased the risk of NHP; in the advanced elderly (age 82+) being widowed and subjective memory impairment were significant predictors for NHP, and cognitive and functional impairment became non-significant as predictors of NHP.

Conclusions

Predictors of NHP may differ in old age groups. The fact that many predictors show inconsistent results as predictors of NHP in the international literature may be attributed to the lack of differentiation in age groups.

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Acknowledgments

This publication is part of the German Research Network on Dementia (KND) and the German Research Network on Degenerative Dementia (KNDD) and was funded by the German Federal Ministry of Education and Research; Grant Number: 01GI0102, 01GI0420, 01GI0422, 01GI0423, 01GI0429, 01GI0431, 01GI0433, 01GI0434, O1GI0710, 01GI0711, 01GI0712, 01GI0713, 01GI0714, 01GI0715, 01GI0716.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Leipzig, Germany

    Melanie Luppa & Tobias Luck

  2. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany

    Steffi G. Riedel-Heller

  3. Institute for Biometrics, Hannover Medical School, Hannover, Germany

    Birgitt Wiese

  4. Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Hendrik van den Bussche, Marion Eisele & Thomas Zimmermann

  5. Department of Psychiatry, University of Bonn, Bonn, Germany

    Franziska Haller, Melanie Sauder & Wolfgang Maier

  6. Department of Psychiatry, Technical University of Munich, Munich, Germany

    Edelgard Mösch & Horst Bickel

  7. Department of General Practice, University Medical Centre, Düsseldorf, Germany

    Michael Pentzek & Anja Wollny

  8. Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Hans-Helmut König

  9. Central Institute for Mental Health, Mannheim, Germany

    Jochen Werle & Siegfried Weyerer

Authors
  1. Melanie Luppa
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  2. Steffi G. Riedel-Heller
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  3. Tobias Luck
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  17. Siegfried Weyerer
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For the AgeCoDe study group

Corresponding author

Correspondence to Melanie Luppa.

Additional information

Further members of the AgeCoDe group: Heinz-Harald Abholz, Matthias C. Angermeyer, Cadja Bachmann, Wolfgang Blank, Mirjam Colditz, Moritz Daerr, Sandra Eifflaender-Gorfer, Angela Fuchs, Frank Jessen, Sven Heinrich, Hanna Kaduszkiewicz, Teresa Kaufeler, Manfred Mayer, Julia Olbrich, Heinz-Peter Romberg, Anja Rudolph, Martina Schäufele, Sandra Schmitz, Britta Schürmann, Janine Stein, Michael Wagner.

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Luppa, M., Riedel-Heller, S.G., Luck, T. et al. Age-related predictors of institutionalization: results of the German study on ageing, cognition and dementia in primary care patients (AgeCoDe). Soc Psychiatry Psychiatr Epidemiol 47, 263–270 (2012). https://doi.org/10.1007/s00127-010-0333-9

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  • DOI: https://doi.org/10.1007/s00127-010-0333-9

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