Marika Salminen1,2, Jenni Vire3, Laura Viikari3, Tero Vahlberg4, Hannu Isoaho5, Aapo Lehtonen3, Matti Viitanen3,6, Seija Arve7, Sini Eloranta7,8. 1. Unit of Family Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, 20014, Turku, Finland. majosa@utu.fi. 2. City of Turku, Welfare division, Yliopistonkatu 30, Turku, Finland. majosa@utu.fi. 3. Department of Geriatrics, Faculty of Medicine, University of Turku, Kunnallissairaalantie 20, Turku, Finland. 4. Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland. 5. Statcon Ltd., Savenvalajankatu 3 B 25, Turku, Finland. 6. Division of clinical geriatrics Karolinska Institute, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden. 7. Department of Nursing Science, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, Turku, Finland. 8. Hospital District of Southwest Finland, Kiinanmyllynkatu 4-8, Turku, Finland.
Abstract
BACKGROUND: Identification of predictive factors on institutionalization provides the basis for the development and application of preadmission assessment. There is a lack of evidence for predictors of institutionalization for older people. AIMS: To examine the effect of predictive factors on institutionalization in home-dwelling 70-year-old people. METHODS: The data were collected in 1991 by the clinical examinations, a postal questionnaire, and an interview from the residents of Turku, Finland, born in 1920 (n = 1032). Institutionalization was defined as entry into a nursing home or sheltered housing at any time during a 22-year follow-up. RESULTS: A rate of institutionalization was 22.0%. In multivariable Cox regression analysis, impaired cognitive function (MMSE 18-26) (hazard ratio 1.71, confidence interval 1.24-2.36) and low BMI (<25 kg/m2) (compared to both BMI of 25-29.9 and that of ≥30, respectively, 1.88, 1.32-2.67, and 1.66, 1.05-2.60), having several falls during the previous year (2.50, 1.28-4.90). CONCLUSIONS: We conclude that impaired cognitive function, low BMI, and frequent falling predicted institutionalization during the 22-year follow-up. To reduce or postpone institutionalization, interventions should target risk factors, such as frailty, physical limitations, and falling. In addition, community-based services according to the needs and functional ability of the home-dwelling older people should be developed.
BACKGROUND: Identification of predictive factors on institutionalization provides the basis for the development and application of preadmission assessment. There is a lack of evidence for predictors of institutionalization for older people. AIMS: To examine the effect of predictive factors on institutionalization in home-dwelling 70-year-old people. METHODS: The data were collected in 1991 by the clinical examinations, a postal questionnaire, and an interview from the residents of Turku, Finland, born in 1920 (n = 1032). Institutionalization was defined as entry into a nursing home or sheltered housing at any time during a 22-year follow-up. RESULTS: A rate of institutionalization was 22.0%. In multivariable Cox regression analysis, impaired cognitive function (MMSE 18-26) (hazard ratio 1.71, confidence interval 1.24-2.36) and low BMI (<25 kg/m2) (compared to both BMI of 25-29.9 and that of ≥30, respectively, 1.88, 1.32-2.67, and 1.66, 1.05-2.60), having several falls during the previous year (2.50, 1.28-4.90). CONCLUSIONS: We conclude that impaired cognitive function, low BMI, and frequent falling predicted institutionalization during the 22-year follow-up. To reduce or postpone institutionalization, interventions should target risk factors, such as frailty, physical limitations, and falling. In addition, community-based services according to the needs and functional ability of the home-dwelling older people should be developed.
Authors: Deepa Alex; Hui M Khor; Ai V Chin; Noran N Hairi; Robert G Cumming; Sajaratulnisah Othman; Selina Khoo; Shahrul B Kamaruzzaman; Maw P Tan Journal: Front Public Health Date: 2020-11-16