title: Age-related predictors of institutionalization: results of the German study on ageing, cognition and dementia in primary care patients (AgeCoDe).
abstract: BACKGROUND
  In the last decades, many community-based studies have addressed predictors of nursing home placement (NHP) among the elderly. So far, predictors have not been analyzed separately for different age groups.
  
  
  METHODS
  For a German GP-sample of 3,208 subjects aged 75 years and older, socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over three waves. Logistic regression models determined predictors of NHP for total sample and for two different age groups. A CART analysis identified factors discriminating best between institutionalized and non-institutionalized individuals.
  
  
  RESULTS
  Of the overall sample, 4.7% of the sample (n = 150) was institutionalized during the study period. Baseline characteristics associated with a higher risk of NHP for the total sample were age, living without spouse, cognitive and functional impairment and depression. In the CART analysis, age was the major discriminator at the first level (at age 81). In subgroup regression analyses, for the younger elderly (age 75-81) being single as well as cognitive and functional impairment increased the risk of NHP; in the advanced elderly (age 82+) being widowed and subjective memory impairment were significant predictors for NHP, and cognitive and functional impairment became non-significant as predictors of NHP.
  
  
  CONCLUSIONS
  Predictors of NHP may differ in old age groups. The fact that many predictors show inconsistent results as predictors of NHP in the international literature may be attributed to the lack of differentiation in age groups.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Leipzig, Germany. Melanie.Luppa@medizin.uni-leipzig.de
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.forename: Tobias
authors.initials: T
authors.lastname: Luck
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.forename: Hendrik
authors.initials: H
authors.lastname: van den Bussche
authors.forename: Franziska
authors.initials: F
authors.lastname: Haller
authors.forename: Melanie
authors.initials: M
authors.lastname: Sauder
authors.forename: Edelgard
authors.initials: E
authors.lastname: Mösch
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.forename: Anja
authors.initials: A
authors.lastname: Wollny
authors.forename: Marion
authors.initials: M
authors.lastname: Eisele
authors.forename: Thomas
authors.initials: T
authors.lastname: Zimmermann
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.forename: Jochen
authors.initials: J
authors.lastname: Werle
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003072:Cognition Disorders / Q000453:epidemiology*; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007326:Institutionalization / Q000639:trends*; D008297:Male; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales