title: Living Alone with Alzheimer's Disease and the Risk of Adverse Outcomes: Results from the Plan de Soin et d'Aide dans la maladie d'Alzheimer Study.
abstract: OBJECTIVE
  To examine whether living alone predicted hospitalizations, nursing home admission, weight loss, and death in individuals with mild to moderate Alzheimer's disease (AD) over 2 years of follow-up.
  
  
  METHODS
  Data are from the Plan de Soin et d'Aide dans la maladie d'Alzheimer study, a 24-month trial with a cluster randomization of memory clinics in two arms: a multidomain intervention and usual care.
  
  
  METHODS
  Memory clinics in France (N = 50).
  
  
  METHODS
  Community-dwelling individuals with AD with a Mini-Mental State Examination score between 12 and 26 and an identified caregiver.
  
  
  METHODS
  A neurogeriatric evaluation was conducted twice a year in the intervention group and annually in the control group. Hospitalizations, nursing home admission, weight loss, and death occurring during the past year were recorded. Information on sociodemographic characteristics, clinical conditions, therapy, and physical and cognitive status was recorded.
  
  
  RESULTS
  At inclusion, 348 (30.8%) of the 1,131 participants lived alone. Living alone did not increase the risk of mortality or weight loss in individuals with mild to moderate AD, but significant associations with risk of hospitalization (hazard ratio (HR) = 1.33, 95% confidence interval (CI) = 1.01-1.74) and institutionalization (HR = 2.53, 95% CI = 1.84-3.47) were reported. A protective effect of physical function on institutionalization and mortality was found.
  
  
  CONCLUSIONS
  These results might support clinicians in making decisions about institutionalization of individuals with AD living alone or improving home health care, such as increasing screening and managing functional impairment in this complex population.
authors.affiliation: Department of Geriatric Medicine, Gérontopôle, Centre Hospitalier Universitaire ToulouseToulouse University Hospital, Toulouse, France; Inserm UMR 1027, Toulouse, France; Université Toulouse III, Toulouse, France.
authors.forename: Maria
authors.initials: M
authors.lastname: Soto
authors.forename: Sandrine
authors.initials: S
authors.lastname: Andrieu
authors.forename: Valérie
authors.initials: V
authors.lastname: Gares
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
authors.forename: Sophie
authors.initials: S
authors.lastname: Gillette-Guyonnet
authors.forename: Christelle
authors.initials: C
authors.lastname: Cantet
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.forename: Fati
authors.initials: F
authors.lastname: Nourhashémi
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000401:mortality / Q000451:nursing*; D005260:Female; D006760:Hospitalization; D006801:Humans; D057187:Independent Living; D007326:Institutionalization; D008297:Male; D009735:Nursing Homes; D011379:Prognosis; D012306:Risk; D015431:Weight Loss
keywords: Alzheimer's; dementia; living alone; older adults; prognosis