Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services
Carina Wattmo, Elisabet Londos, Lennart Minthon Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö, SwedenIntroduction: Many individuals with Alzheimer’s disease (AD) live alone, and this figure is expected to increase. This stud...
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Dove Medical Press
2014
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oai:doaj.org-article:dc58d0bacf724e11962c613a6596e9e22021-12-02T00:19:07ZSolitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services1178-1998https://doaj.org/article/dc58d0bacf724e11962c613a6596e9e22014-11-01T00:00:00Zhttps://www.dovepress.com/solitary-living-in-alzheimerrsquos-disease-over-3nbspyears-association-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Carina Wattmo, Elisabet Londos, Lennart Minthon Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö, SwedenIntroduction: Many individuals with Alzheimer’s disease (AD) live alone, and this figure is expected to increase. This study aimed to describe the cognitive and functional abilities of solitary-living AD patients, and the potential predictors of their usage of community-based services.Methods: This 3-year, prospective, multicenter study included 1,021 participants with mild-to-moderate AD (Mini-Mental State Examination score, 10–26) treated with a cholinesterase inhibitor in a routine clinical setting. At baseline and every 6 months, patients were assessed using cognitive, instrumental, and basic activities of daily living (ADL) scales, and service utilization was recorded. Logistic regression models were used to predict the usage of community-based services.Results: At the start of cholinesterase inhibitor therapy (time of AD diagnosis), 355 individuals (35%) were living alone. They were mainly female, older, had more impaired basic ADL capacity, and had a larger number of concomitant medications when compared with those living with family. Regarding the solitary-living patients, lower instrumental ADL (IADL) ability and more medications were independent predictors of usage of home-help services, whereas more impaired IADL at baseline and faster IADL deterioration were predictors of nursing home admission. For those living with family, older age, lower basic ADL, and a greater number of medications predicted home-help services, whereas a larger amount of home help predicted nursing home placement. In addition, female sex was a risk factor for both the utilization of home-help services and nursing home placement. Cognitive ability was not significantly associated with the usage of community-based services.Conclusion: A large number of AD patients, predominantly females, live alone with severe cognitive and functional impairment. The amount of home-help services used did not reflect cognitive severity, suggesting that home help did not meet the needs related to cognitive deterioration. Increased knowledge of how community-based services can better accommodate the care needs of solitary-living individuals with AD is essential.Keywords: cognition, activities of daily living, living status, home-help services, nursing home placement, longitudinal studyWattmo CLondos EMinthon LDove Medical PressarticleCognitionActivities of daily livingLiving statusHome-help servicesNursing-home placementLongitudinal studyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1951-1962 (2014) |
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Cognition Activities of daily living Living status Home-help services Nursing-home placement Longitudinal study Geriatrics RC952-954.6 |
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Cognition Activities of daily living Living status Home-help services Nursing-home placement Longitudinal study Geriatrics RC952-954.6 Wattmo C Londos E Minthon L Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| description |
Carina Wattmo, Elisabet Londos, Lennart Minthon Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö, SwedenIntroduction: Many individuals with Alzheimer’s disease (AD) live alone, and this figure is expected to increase. This study aimed to describe the cognitive and functional abilities of solitary-living AD patients, and the potential predictors of their usage of community-based services.Methods: This 3-year, prospective, multicenter study included 1,021 participants with mild-to-moderate AD (Mini-Mental State Examination score, 10–26) treated with a cholinesterase inhibitor in a routine clinical setting. At baseline and every 6 months, patients were assessed using cognitive, instrumental, and basic activities of daily living (ADL) scales, and service utilization was recorded. Logistic regression models were used to predict the usage of community-based services.Results: At the start of cholinesterase inhibitor therapy (time of AD diagnosis), 355 individuals (35%) were living alone. They were mainly female, older, had more impaired basic ADL capacity, and had a larger number of concomitant medications when compared with those living with family. Regarding the solitary-living patients, lower instrumental ADL (IADL) ability and more medications were independent predictors of usage of home-help services, whereas more impaired IADL at baseline and faster IADL deterioration were predictors of nursing home admission. For those living with family, older age, lower basic ADL, and a greater number of medications predicted home-help services, whereas a larger amount of home help predicted nursing home placement. In addition, female sex was a risk factor for both the utilization of home-help services and nursing home placement. Cognitive ability was not significantly associated with the usage of community-based services.Conclusion: A large number of AD patients, predominantly females, live alone with severe cognitive and functional impairment. The amount of home-help services used did not reflect cognitive severity, suggesting that home help did not meet the needs related to cognitive deterioration. Increased knowledge of how community-based services can better accommodate the care needs of solitary-living individuals with AD is essential.Keywords: cognition, activities of daily living, living status, home-help services, nursing home placement, longitudinal study |
| format |
article |
| author |
Wattmo C Londos E Minthon L |
| author_facet |
Wattmo C Londos E Minthon L |
| author_sort |
Wattmo C |
| title |
Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| title_short |
Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| title_full |
Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| title_fullStr |
Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| title_full_unstemmed |
Solitary living in Alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| title_sort |
solitary living in alzheimer’s disease over 3 years: association between cognitive and functional impairment and community-based services |
| publisher |
Dove Medical Press |
| publishDate |
2014 |
| url |
https://doaj.org/article/dc58d0bacf724e11962c613a6596e9e2 |
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