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Open Access Highly Accessed Research article

Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+)

Melanie Luppa12*, Tobias Luck123, Herbert Matschinger4, Hans-Helmut König5 and Steffi G Riedel-Heller2

Author Affiliations

1 Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig, (Semmelweisstraße 10), Leipzig, (04103), Germany

2 Department of Social Medicine, University of Leipzig, (Philipp-Rosenthal-Straße 55), Leipzig, (04103), Germany

3 LIFE Center, University of Leipzig, (Philipp-Rosenthal-Straße 27), Leipzig, (04103), Germany

4 Department of Psychiatry and Psychotherapy, University of Leipzig, (Semmelweisstraße 10), Leipzig, (04103), Germany

5 University Medical Center Hamburg-Eppendorf, Department of Medical Sociology and Health Economics, (Martinistraße 52), Hamburg, (20246), Germany

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BMC Health Services Research 2010, 10:186  doi:10.1186/1472-6963-10-186

Published: 29 June 2010

Abstract

Background

In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA) among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA.

Methods

Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA.

Results

Of the overall sample, 7.8 percent of the non-demented elderly (n = 59) were admitted to nursing home (NH) during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use.

Conclusions

Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.