OBJECTIVES: 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. DESIGN: 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. SETTING:Memory clinics in France (N = 50). PARTICIPANTS: Community-dwelling individuals with AD with a Mini-Mental State Examination score between 12 and 26 and an identified caregiver. MEASUREMENTS: 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. CONCLUSION: 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.
RCT Entities:
OBJECTIVES: 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. DESIGN: 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. SETTING: Memory clinics in France (N = 50). PARTICIPANTS: Community-dwelling individuals with AD with a Mini-Mental State Examination score between 12 and 26 and an identified caregiver. MEASUREMENTS: 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. CONCLUSION: 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: Elena Portacolone; Julene K Johnson; Kenneth E Covinsky; Jodi Halpern; Robert L Rubinstein Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
Authors: Pavla Cermakova; Maja Nelson; Juraj Secnik; Sara Garcia-Ptacek; Kristina Johnell; Johan Fastbom; Lena Kilander; Bengt Winblad; Maria Eriksdotter; Dorota Religa Journal: J Alzheimers Dis Date: 2017 Impact factor: 4.472
Authors: Amy Rosenwohl-Mack; Leslie Dubbin; Anna Chodos; Sarah Dulaney; Min-Lin Fang; Jennifer Merrilees; Elena Portacolone Journal: Innov Aging Date: 2021-01-18