Predictors of institutionalization for people with multiple sclerosis
| Autor: | Rochelle Jalbert, Lilian Thorpe, Katherine B. Knox, Walter J. Hader, Darren Nickel, June Hyun-Ja Lim |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Pediatrics Canada Multiple Sclerosis Urban Population Institutionalisation Kurtzke Expanded Disability Status Scale Severity of Illness Index Disability Evaluation Activities of Daily Living medicine Humans Disabled Persons Longitudinal Studies Severe disability Proportional Hazards Models Brain Diseases Proportional hazards model business.industry Multiple sclerosis Public Health Environmental and Occupational Health Age Factors Institutionalization General Medicine Middle Aged medicine.disease Functional system Nursing Homes Urinary Incontinence Chronic Disease Physical therapy Disease Progression Regression Analysis Female Age of onset business Progressive disease |
| Zdroj: | Disability and health journal. 8(2) |
| ISSN: | 1876-7583 |
| Popis: | Background Multiple Sclerosis (MS) is a chronic, progressive disease of the central nervous system with a high prevalence in Canada. While the disease course is highly variable, a significant portion of people with MS may spend more than 10 years living with severe disability, and many of those will eventually require full time institutional care. Despite the high personal and economic cost of this care, little is known about predictors of institutionalization. Objective The objective of this study was to identify predictors of institutionalization. Methods Longitudinal data from a university MS clinic database were extracted to explore nursing home placement over time of an urban subgroup. Cox regression analysis was performed with age of MS onset and sex, as well as baseline information obtained at the first MS clinic assessment: MS course, Kurtzke Expanded Disability Status Scale score, and functional system scores. Results Older age of onset (p = .019) and higher baseline scores in specific functional systems (cerebellar, bowel/bladder, brainstem, and cerebral/mental) were significant (p = .000, p = .000, p = .001, p = .000 respectively) predictors of nursing home placement. Conclusions Patients with older age of MS onset and those with baseline impairment in specific functional systems (cerebellar, bowel/bladder, brainstem, and cerebral/mental) may be at higher risk for future institutionalization and should be assessed with particular care to determine potential avenues of support to minimize this. |
| Databáze: | OpenAIRE |
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