title: Factors associated with permanent transition from independent living to nursing home in a continuing care retirement community.
abstract: OBJECTIVE
  Identify risk factors for and time to permanent transition from independent living units to nursing home among residents in a continuing care retirement community (CCRC).
  
  
  METHODS
  Prospective cohort study (n=298) among residents at least 75 years of age living independently at baseline. Proportional hazard regression identified risk factors associated with permanent transition from sociodemographic and health status data.
  
  
  RESULTS
  During the 3-year follow-up, 11% of the subjects were permanently transferred. Predictive factors were depression (relative risk [RR] 3.9; 95% CI 1.5-9.8), incontinence (RR 3.8; 95% CI 1.3-11.4), impaired cognition (RR 3.6; 95% CI 1.1-11.3), and dependence on activities of daily living disability (RR 1.5; 95% CI 1.3-1.8). Compared with those with no risk factors, presence of all 4 increased the relative risk to 74-fold and shortened the time to permanent transition by 32 months.
  
  
  CONCLUSIONS
  Prevention and treatment for depression, incontinence, and programs to improve or maintain cognitive function and ability to perform activities of daily living among CCRC residents may prolong their independent living life.
authors.affiliation: State University of New York (SUNY) at Albany, School of Public Health, Rensselaer, NY 12144, USA. yyoung@albany.edu
authors.forename: Yuchi
authors.initials: Y
authors.lastname: Young
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D015331:Cohort Studies; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008485:Medical Audit; D009735:Nursing Homes; D010360:Patient Transfer; D011446:Prospective Studies; D011795:Surveys and Questionnaires