Affiliation:
1. Department of Industrial Engineering and Management, School of Science, Aalto University, Espoo, Finland
2. MedEngine Oy, Helsinki, Finland
3. Ministry of Finance Finland
4. Social Insurance Institution Finland
5. Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland
Abstract
Background: Dementia is one of the strongest predictors of admission to a 24-hour care facility among older people, and 24-hour care is the major cost of Alzheimer’s disease (AD). Objective: The aim of this study was to evaluate the association of early start of anti-dementia medication and other predisposing factors with 2-year risk of transition to 24-hour care in the nationwide cohort of Finnish AD patients. Methods: This was a retrospective, non-interventional study based on individual-level data from Finnish national health and social care registers. The incident cohort included 7,454 AD patients (ICD-10, G30) comprised of two subgroups: those living unassisted at home (n = 5,002), and those receiving professional home care (n = 2,452). The primary outcome was admission to a 24-hour care facility. Exploratory variables were early versus late anti-dementia medication start, sociodemographic variables, care intensity level, and comorbidities. Results: Early anti-dementia medication reduced the risk of admission to 24-hour care both in patients living unassisted at home, with a hazard ratio (HR) of 0.58 (p < 0.001), and those receiving professional home care (HR, 0.84; p = 0.039). Being unmarried (HR, 1.69; p < 0.001), having an informal caregiver (HR, 1.69; p = 0.003), or having a diagnosis of additional neurological disorder (HR, 1.68; p = 0.006) or hip fracture (HR, 1.61; p = 0.004) were associated with higher risk of admission to 24-hour care in patients living unassisted at home. Conclusion: To support living at home, early start of anti-dementia medication should be a high priority in newly diagnosed AD patients.
Subject
Psychiatry and Mental health,Geriatrics and Gerontology,Clinical Psychology,General Medicine,General Neuroscience
Reference28 articles.
1. Wimo A , Jönsson B , Karlsson G , Winblad B (1998) Health economics of dementia. John Wiley & Sons, Chichester.
2. Prince M , Wimo A , Guerchet M , Ali GC , Wu Y PA (2015) World Alzheimer Report 2015. The global impact of dementia: An analysis of prevalence, incidence, costs and trends. Alzheimer’s Disease International, London.
3. Impact of anti-dementia medication on the risk of death and causes of death in Alzheimer’s disease;Linna;J Alzheimers Dis,2019
4. Chronic conditions and the risk of long-term institutionalization among older people;Nihtilä;Eur J Public Health,2007
5. Predictors of institutionalization in dementia: A three year longitudinal study;Brodaty;J Alzheimers Dis,2014
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