Impact of Cognitive, Functional, Behavioral Disorders, and Caregiver Burden on the Risk of Nursing Home Placement
| Autor: | Marine Dufournet, Virginie Dauphinot, Claire Moutet, Mathieu Verdurand, Floriane Delphin-Combe, Pierre Krolak-Salmon, Florian Delphin-Combe, Zaza Makaroff, Denis Federico, Marie-Hélène Coste, Isabelle Rouch, Jean-Michel Dorey, Alexis Lepetit, Keren Danaila, Julien Vernaudon, Anthony Bathsavanis, Alain Sarciron, Yves Guilhermet, Sylvain Gaujard, Pierre Grosmaître |
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| Přispěvatelé: | Centre Mémoire de Ressources et de Recherche Lyon (CMRR), Hospices Civils de Lyon (HCL)-Hôpital des Charpennes [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Mémoire de Ressources et de Recherche [Lyon] (CMRR), MEMORA group: Pierre Krolak-Salmon, Virginie Dauphinot, Florian Delphin-Combe, Zaza Makaroff, Denis Federico, Marie-Hélène Coste, Isabelle Rouch, Jean-Michel Dorey, Alexis Lepetit, Keren Danaila, Julien Vernaudon, Anthony Bathsavanis, Alain Sarciron, Yves Guilhermet, Sylvain Gaujard, Pierre Grosmaître, Claire Moutet, Mathieu Verdurand, CCSD, Accord Elsevier, Centre de recherche en neurosciences de Lyon (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Longitudinal study Activities of daily living [SDV]Life Sciences [q-bio] Psychological intervention neurocognitive disorders functional limitations Risk Assessment Nursing home placement 03 medical and health sciences Patient Admission 0302 clinical medicine Cost of Illness medicine Humans Dementia Cognitive Dysfunction Apathy Longitudinal Studies 030212 general & internal medicine Psychiatry General Nursing Aged Aged 80 and over caregiver burden business.industry Health Policy General Medicine Caregiver burden medicine.disease Nursing Homes 3. Good health [SDV] Life Sciences [q-bio] Caregivers Attention Deficit and Disruptive Behavior Disorders Attributable risk Anxiety Female neuropsychiatric symptoms France Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery dementia |
| Zdroj: | Journal of the American Medical Directors Association Journal of the American Medical Directors Association, 2019, 20, pp.1254-1262. ⟨10.1016/j.jamda.2019.03.027⟩ Journal of the American Medical Directors Association, Elsevier, 2019, 20, pp.1254-1262. ⟨10.1016/j.jamda.2019.03.027⟩ |
| ISSN: | 1525-8610 |
| Popis: | Objectives To estimate the attributable fraction of nursing home placement associated with cognitive impairment, neuropsychiatric symptoms, behavioral disorders, functional limitations, and caregiver burden. Design Longitudinal study conducted on the “MEMORA cohort” linked with both regional public health insurance and hospital discharge databases. Setting Memory center at the University Hospital of Lyon, France. Participants A sample of 2456 outpatients attending the memory center between 2012 and 2017. Measures Cognitive impairment, functional limitations, neuropsychiatric symptoms/behavioral disorders, and caregiver burden were measured with the Mini-Mental State Examination, the Instrumental Activities of Daily Living scale, the Neuropsychiatric Inventory (NPI), and a short version of the Zarit Burden Inventory, respectively. Sociodemographics characteristics were collected during the first visit. Comorbidities were gathered from the hospital discharge database. Dates of nursing home placement were obtained from the public health insurance database. Results More than 38% of nursing home placements were attributable to caregiver burden, and the attributable fraction associated with functional limitations exceeded 35%. Between 20% and 25% of nursing home placements were due to cognitive impairment whereas less than 16% were attributable to neuropsychiatric symptoms or behavioral disorders. The associations between anxiety or agitation and nursing home placement were mediated by caregiver burden. Apathy or aberrant motor behaviors were associated with a higher risk of nursing home placement independently of caregiver burden. Conclusions/Implications Our findings suggest that a high proportion of nursing home placements are attributable to caregiver burden and functional limitations in outpatients attending a memory center. Cognitive impairment and neuropsychiatric symptoms or behavioral disorders contribute less to nursing home placements. Interventions directed to delay nursing home placement should emphasize actions toward reducing caregiver burden and functional limitations of patients. |
| Databáze: | OpenAIRE |
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