title: The impact of dementia on care transitions during the last two years of life.
abstract: BACKGROUND
  Dementia is one of the main challenges to our health and social care. This study compares the number and timing of transitions between care settings in the last 2 years of life among older people with and without dementia.
  
  
  METHODS
  Data were derived from Finnish national registers, and include all those who died in 2002 and 2003 at the age of 70 or older (n = 70,366). Negative binomial regression analyses were used to analyse the impact of dementia on number of transitions among people with and without dementia and to adjust the number for age, gender and other diagnoses.
  
  
  RESULTS
  In the group that lived at home 2 years before death people with a dementia diagnosis had 32% more care transitions than people without dementia, while the group that was in residential care facility 2 years before death people with dementia had 12% fewer moves than those without dementia The average number of transition was highest in last 3 months of life. People with dementia had their last move more often between care facilities and hospitals offering basic health care than people without dementia.
  
  
  CONCLUSIONS
  Dementia has a significant impact on the number and type of transitions. As the number of people with dementia increases, the quality and equity of care of these patients in their last years constitute a special challenge.
authors.affiliation: School of Health Sciences, University of Tampere, Tampere FIN-33014, Finland. mari.s.aaltonen@uta.fi
authors.forename: Mari
authors.initials: M
authors.lastname: Aaltonen
authors.forename: Pekka
authors.initials: P
authors.lastname: Rissanen
authors.forename: Leena
authors.initials: L
authors.lastname: Forma
authors.forename: Jani
authors.initials: J
authors.lastname: Raitanen
authors.forename: Marja
authors.initials: M
authors.lastname: Jylhä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care; D003704:Dementia / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D012112:Residential Facilities / Q000706:statistics & numerical data