Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis
Background: Up to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing ho...
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| Format: | Article |
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Cambridge University Press
2016
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| Online Access: | https://eprints.nottingham.ac.uk/42612/ |
| _version_ | 1848796526850080768 |
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| author | Toot, Sandeep Swinson, Tom Devine, Mike Challis, David Orrell, Martin |
| author_facet | Toot, Sandeep Swinson, Tom Devine, Mike Challis, David Orrell, Martin |
| author_sort | Toot, Sandeep |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Up to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing home. Robust evidence is needed as to the causes of admission to nursing homes, particularly where these risk factors are modifiable.
Methods: We conducted a systematic literature search to identify controlled comparison studies in which the primary outcome was admission to nursing home of older adults with dementia. Identified studies were assessed for validity and 26 (17 cohort and 9 case-control) were included. Qualitative and quantitative analyses were conducted, including meta-analysis of 15 studies.
Results: Poorer cognition and behavioral and psychological symptoms of dementia (BPSD) were consistently associated with an increased risk of nursing home admission and most of our meta-analyses demonstrated impairments in activities of daily living as a significant risk. The effects of community support services were unclear, with both high and low levels of service use leading to nursing home placement. There was an association between caregiver burden and risk of institutionalization, but findings with regard to caregiver depression varied, as did physical health associations, with some studies showing an increased risk of nursing home placement following hip fracture, reduced mobility, and multiple comorbidities.
Conclusion: We recommend focusing on cognitive enhancement strategies, assessment and management of BPSD, and carer education and support to delay nursing home placement. |
| first_indexed | 2025-11-14T19:49:23Z |
| format | Article |
| id | nottingham-42612 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:49:23Z |
| publishDate | 2016 |
| publisher | Cambridge University Press |
| recordtype | eprints |
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| spelling | nottingham-426122020-05-04T18:22:37Z https://eprints.nottingham.ac.uk/42612/ Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis Toot, Sandeep Swinson, Tom Devine, Mike Challis, David Orrell, Martin Background: Up to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing home. Robust evidence is needed as to the causes of admission to nursing homes, particularly where these risk factors are modifiable. Methods: We conducted a systematic literature search to identify controlled comparison studies in which the primary outcome was admission to nursing home of older adults with dementia. Identified studies were assessed for validity and 26 (17 cohort and 9 case-control) were included. Qualitative and quantitative analyses were conducted, including meta-analysis of 15 studies. Results: Poorer cognition and behavioral and psychological symptoms of dementia (BPSD) were consistently associated with an increased risk of nursing home admission and most of our meta-analyses demonstrated impairments in activities of daily living as a significant risk. The effects of community support services were unclear, with both high and low levels of service use leading to nursing home placement. There was an association between caregiver burden and risk of institutionalization, but findings with regard to caregiver depression varied, as did physical health associations, with some studies showing an increased risk of nursing home placement following hip fracture, reduced mobility, and multiple comorbidities. Conclusion: We recommend focusing on cognitive enhancement strategies, assessment and management of BPSD, and carer education and support to delay nursing home placement. Cambridge University Press 2016-11-03 Article PeerReviewed Toot, Sandeep, Swinson, Tom, Devine, Mike, Challis, David and Orrell, Martin (2016) Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis. International Psychogeriatrics, 29 (2). pp. 195-208. ISSN 1741-203X Older adults Dementia Nursing home placement Risk factors https://www.cambridge.org/core/journals/international-psychogeriatrics/article/causes-of-nursing-home-placement-for-older-people-with-dementia-a-systematic-review-and-metaanalysis/62B350693121CB1E1B109714A58CD343 doi:10.1017/S1041610216001654 doi:10.1017/S1041610216001654 |
| spellingShingle | Older adults Dementia Nursing home placement Risk factors Toot, Sandeep Swinson, Tom Devine, Mike Challis, David Orrell, Martin Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| title | Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| title_full | Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| title_fullStr | Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| title_full_unstemmed | Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| title_short | Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| title_sort | causes of nursing home placement for older people with dementia: a systematic review and meta-analysis |
| topic | Older adults Dementia Nursing home placement Risk factors |
| url | https://eprints.nottingham.ac.uk/42612/ https://eprints.nottingham.ac.uk/42612/ https://eprints.nottingham.ac.uk/42612/ |