Cohort Study on Predictors of Need for Nursing Care in Alzheimer’s Disease: An Analysis of Healthcare Data
| Autor: | Maren Gaudig, Bernd Brüggenjürgen, Stefan N. Willich, Nadja Ezzat, J. Burkowitz, Frank Andersohn |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Disease Cohort Studies 03 medical and health sciences Nursing care 0302 clinical medicine Alzheimer Disease Predictive Value of Tests Diabetes mellitus Health care medicine Humans 030212 general & internal medicine Intensive care medicine Aged Retrospective Studies Aged 80 and over Health Services Needs and Demand business.industry General Neuroscience Retrospective cohort study General Medicine Middle Aged Stepwise regression medicine.disease Psychiatry and Mental health Clinical Psychology Malnutrition Data Interpretation Statistical Family medicine Female Nursing Care Geriatrics and Gerontology business 030217 neurology & neurosurgery Follow-Up Studies Cohort study |
| Zdroj: | Journal of Alzheimer's Disease. 54:1365-1372 |
| ISSN: | 1875-8908 1387-2877 |
| DOI: | 10.3233/jad-160137 |
| Popis: | BACKGROUND The individual and societal burden of Alzheimer's disease (AD) is substantial. Identifying relevant factors deteriorating AD and inducing need for nursing care would be of high relevance for healthcare planning. OBJECTIVE The main objective of this study was the identification of predictors of first assignment of a level of long-term care in AD, used as an approximation for disease progression. METHODS In a retrospective cohort study using data from a large German statutory health and long-term care insurance (SHI) company, co-morbidities and drug exposure were evaluated with respect to their predictive value for disease progression (first day the amount of daily nursing care exceeded 1.5 hours). Time to disease progression was modeled using COX-proportional hazard regression with stepwise selection of predictor variables. RESULTS The risk of nursing care need increased substantially with increasing age. Number of hospitalizations and number of different drugs used were significant indicators for progression, whereas outpatient visits were associated with a reduced need for care. Gender did not indicate significant influence on progression. Malignant neoplasms of ill-defined, secondary, and unspecified sites, malnutrition, renal failure, and injuries increased the risk of need for nursing care most significantly. Among prescribed drugs, significant increased risks were associated with drugs used in diabetes, preparations for treatment of wounds and ulcers, antiseptics and disinfectants, and analgesics. CONCLUSIONS Physical comorbidities are relevant contributors to an increase in need for nursing care. Some medical predicting conditions may be linked to cognition, while others may be directly linked to demand for care. AD patients with these comorbidities should be monitored with special attention, as they may be under an increased risk of care dependency. |
| Databáze: | OpenAIRE |
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