Early Start of Anti-Dementia Medication Delays Transition to 24-Hour Care in Alzheimer's Disease Patients: A Finnish Nationwide Cohort Study.
J Alzheimers Dis
; 81(3): 1103-1115, 2021.
Article
en En
| MEDLINE
| ID: mdl-33843673
ABSTRACT
BACKGROUND:
Dementia is one of the strongest predictors of admission to a 24-hour care facility among older people, and 24-hour care is the major cost of Alzheimer's disease (AD).OBJECTIVE:
The aim of this study was to evaluate the association of early start of anti-dementia medication and other predisposing factors with 2-year risk of transition to 24-hour care in the nationwide cohort of Finnish AD patients.METHODS:
This was a retrospective, non-interventional study based on individual-level data from Finnish national health and social care registers. The incident cohort included 7,454 AD patients (ICD-10, G30) comprised of two subgroups those living unassisted at home (nâ=â5,002), and those receiving professional home care (nâ=â2,452). The primary outcome was admission to a 24-hour care facility. Exploratory variables were early versus late anti-dementia medication start, sociodemographic variables, care intensity level, and comorbidities.RESULTS:
Early anti-dementia medication reduced the risk of admission to 24-hour care both in patients living unassisted at home, with a hazard ratio (HR) of 0.58 (pâ<â0.001), and those receiving professional home care (HR, 0.84; pâ=â0.039). Being unmarried (HR, 1.69; pâ<â0.001), having an informal caregiver (HR, 1.69; pâ=â0.003), or having a diagnosis of additional neurological disorder (HR, 1.68; pâ=â0.006) or hip fracture (HR, 1.61; pâ=â0.004) were associated with higher risk of admission to 24-hour care in patients living unassisted at home.CONCLUSION:
To support living at home, early start of anti-dementia medication should be a high priority in newly diagnosed AD patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Inhibidores de la Colinesterasa
/
Nootrópicos
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Enfermedad de Alzheimer
/
Casas de Salud
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Alzheimers Dis
Asunto de la revista:
GERIATRIA
/
NEUROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Finlandia