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PLoS One. 2015 Dec 14;10(12):e0144203. doi: 10.1371/journal.pone.0144203. eCollection 2015.

Longitudinal Predictors of Institutionalization in Old Age.

Author information

1
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
2
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
3
WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
4
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
5
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
6
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
7
Department of Psychiatry, Technical University of Munich, Munich, Germany.
8
Department of Psychiatry, University of Bonn, Bonn, Germany.
9
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
10
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.

Abstract

OBJECTIVE:

To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach.

METHODS:

In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional fixed-effects logistic regressions (with 201 individuals and 960 observations) were performed to estimate the effects of marital status, depression, dementia, and physical impairments (mobility, hearing and visual impairments) on the risk of admission to old-age home or nursing home. By exploiting the longitudinal data structure using panel econometric models, we were able to control for unobserved heterogeneity such as genetic predisposition and personality traits.

RESULTS:

The probability of institutionalization increased significantly with occurrence of widowhood, depression, dementia, as well as walking and hearing impairments. In particular, the occurrence of widowhood (OR = 78.3), dementia (OR = 154.1) and substantial mobility impairment (OR = 36.7) were strongly associated with institutionalization.

CONCLUSION:

Findings underline the strong influence of loss of spouse as well as dementia on institutionalization. This is relevant as the number of old people (a) living alone and (b) suffering from dementia is expected to increase rapidly in the next decades. Consequently, it is supposed that the demand for institutionalization among the elderly will increase considerably. Practitioners as well as policy makers should be aware of these upcoming challenges.

PMID:
26658776
PMCID:
PMC4685990
DOI:
10.1371/journal.pone.0144203
[Indexed for MEDLINE]
Free PMC Article

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