PMID- 35574920
OWN - NLM
STAT- Publisher
LR  - 20240216
IS  - 1099-1166 (Electronic)
IS  - 0885-6230 (Print)
IS  - 0885-6230 (Linking)
VI  - 37
IP  - 6
DP  - 2022 Apr 30
TI  - Predictors of nursing home placement at 2 years in Alzheimer's disease: A 
      follow-up survey from the THERAD study.
LID - 10.1002/gps.5724 [doi]
AB  - OBJECTIVES: Nursing Home Placement (NHP) can prove to be the only solution to 
      some dead-end situations in Alzheimer's disease (AD). The predictors of NHP are 
      known and can be related to either the person with dementia or his/her caregiver. 
      We aimed to identify predictors of NHP among people with AD over a 2-year 
      follow-up period, with a particular interest in the modifiable predictors, 
      notably those involving caregivers. METHODS: We studied data from the THERAD 
      study, a French monocentric randomized controlled trial, involving 196 
      community-dwelling dyads, primarily assessing an educational intervention in AD. 
      We performed a bivariate analysis followed by a multivariate Cox model, with a 
      backward stepwise procedure. RESULTS: The mean age of the patients was 82 years 
      old, 67.7% were women and 56.9% were living with a partner. The mean age of the 
      caregivers was 65.8 years old, 64.6% were women and half were spouses of the 
      patients with a moderate burden. During the follow-up, 23 patients died and 49 
      were institutionalized. The majority of NHPs occurred during the first year (35 
      NHP). The mean time to NHP was 27.77 months after the diagnosis. Five independent 
      predictors of NHP were found: a higher patient education level (aHR 6.31; 
      CI95% = 1.88-21.22), a high caregiver Burden (aHR 3.97; CI95% = 1.33-11.85), the 
      caregiver being the offspring of the patient (aHR 2.92; CI95% = 1.43-5.95), loss 
      of autonomy (aHR 2.75; CI95% = 1.13-6.65) and disinhibition as a behavioural and 
      psychological symptoms of dementia (BPSD) (aHR 2.38; CI95% = 1.26-4.47). 
      CONCLUSIONS: Our data are in accordance with the literature in identifying loss 
      of autonomy, burden and BPSD (disinhibition) as risk factors of NHP. We also 
      found high patient education level and status of offspring caregiver as 
      additional factors. It is essential to take into account the caregiver status 
      when designing psychoeducational trials aiming to delay NHP. Further studies need 
      to take into account both the modifiable risk factors related to the patient 
      (productive BPSD) and the needs of offspring caregivers (work-life balance, 
      mental load).
CI  - (c) 2022 The Authors. International Journal of Geriatric Psychiatry published by 
      John Wiley & Sons Ltd.
FAU - Villars, Helene
AU  - Villars H
AUID- ORCID: 0000-0001-7668-1808
AD  - Geriatric Department, Toulouse University Hospital, Toulouse, France.
AD  - Department of Epidemiology and Public Health, Inserm UMR 1295, Centre for 
      Research in Population Health (CERPOP), Toulouse, France.
FAU - Gardette, Virginie
AU  - Gardette V
AD  - Geriatric Department, Toulouse University Hospital, Toulouse, France.
AD  - Department of Epidemiology and Public Health, Inserm UMR 1295, Centre for 
      Research in Population Health (CERPOP), Toulouse, France.
FAU - Frayssignes, Pauline
AU  - Frayssignes P
AD  - Geriatric Department, Toulouse University Hospital, Toulouse, France.
FAU - Deperetti, Eva
AU  - Deperetti E
AD  - Geriatric Department, Toulouse University Hospital, Toulouse, France.
FAU - Perrin, Amelie
AU  - Perrin A
AD  - Geriatric Department, Toulouse University Hospital, Toulouse, France.
FAU - Cantet, Christelle
AU  - Cantet C
AD  - Department of Epidemiology and Public Health, Inserm UMR 1295, Centre for 
      Research in Population Health (CERPOP), Toulouse, France.
FAU - Soto-Martin, Maria
AU  - Soto-Martin M
AD  - Geriatric Department, Toulouse University Hospital, Toulouse, France.
AD  - Department of Epidemiology and Public Health, Inserm UMR 1295, Centre for 
      Research in Population Health (CERPOP), Toulouse, France.
LA  - eng
GR  - Fondation Mederic Alzheimer/
GR  - Ministere des Affaires sociales, de la Sante et des Droits des femmes/
PT  - Journal Article
DEP - 20220430
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
SB  - IM
PMC - PMC9323428
OTO - NOTNLM
OT  - Alzheimer's disease
OT  - burden
OT  - dyadic approach
OT  - nursing home
OT  - offspring caregivers
COIS- The authors declare no conflicts of interest.
EDAT- 2022/05/17 06:00
MHDA- 2022/05/17 06:00
PMCR- 2022/07/26
CRDT- 2022/05/16 05:57
PHST- 2021/10/31 00:00 [received]
PHST- 2022/04/20 00:00 [accepted]
PHST- 2022/05/16 05:57 [entrez]
PHST- 2022/05/17 06:00 [pubmed]
PHST- 2022/05/17 06:00 [medline]
PHST- 2022/07/26 00:00 [pmc-release]
AID - GPS5724 [pii]
AID - 10.1002/gps.5724 [doi]
PST - aheadofprint
SO  - Int J Geriatr Psychiatry. 2022 Apr 30;37(6):10.1002/gps.5724. doi: 
      10.1002/gps.5724.