Prediction of institutionalisation in dementia. A systematic review.
OBJECTIVE
In the past decades, a substantial number of studies considered factors influencing institutionalisation of persons with dementia. This study reviews recent work on predictors of actual institutionalisation in dementia.


METHODS
Relevant articles were identified by a systematic search of the literature. Studies were considered which included persons aged 65 and over, and whose results were based on prospective design and on multivariate statistical analyses.


RESULTS
Forty-two studies were identified. The rate of institutionalisation increased from 20% in the first year after diagnosis to 50% after 5 years. Median time to institutionalisation was estimated between 30 and 40 months. Predictors of institutionalisation were classified according to a provided conceptual framework in the categories sociodemographic and relationship characteristics of persons with dementia and caregivers, primary stressors, secondary stressors and resources.


CONCLUSIONS
The overview of research activities in this area showed a lack of methodological strength in a large part of identified studies. Nevertheless, a lot of well-examined and less highlighted predictors could be identified.
Luppa
Melanie
M
Department of Psychiatry, Public Mental Health Research Unit, University of Leipzig, Leipzig, Germany. Melanie.Luppa@medizin.uni-leipzig.de
Luck
Tobias
T
Brähler
Elmar
E
König
Hans-Helmut
HH
Riedel-Heller
Steffi G
SG
D000368:Aged; D003704:Dementia / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests