title: Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+).
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.
authors.affiliation: Department of Psychiatry and Psychotherapy, Public Health Research Unit, University of Leipzig, (Semmelweisstrasse 10), Leipzig, (04103), Germany. melanie.luppa@medizin.uni-leipzig.de
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Tobias
authors.initials: T
authors.lastname: Luck
authors.forename: Herbert
authors.initials: H
authors.lastname: Matschinger
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D009735:Nursing Homes; D010343:Patient Admission; D016016:Proportional Hazards Models