Prediction of institutionalisation in dementia - A systematic review

Background/Aims: In the past decades, a substantial number of studies considered factors influencing institutionalisation of persons with dementia. This study reviews recent work on predictors of actual institutionalisation in dementia. Method: Relevant articles were identified by a systematic search of the literature. Studies were considered which included persons aged 65 and over, and whose results were based on prospective design and on multivariate statistical analyses. Results: Forty-two studies were identified. The rate of institutionalisation increased from 20% in the first year after diagnosis to 50% after 5 years. Median time to institutionalisation was estimated between 30 and 40 months. Predictors of institutionalisation were classified according to a provided conceptual framework in the categories sociodemographic and relationship characteristics of persons with dementia and caregivers, primary stressors, secondary stressors and resources. Conclusion: The overview of research activities in this area showed a lack of methodological strength in a large part of identified studies. Nevertheless, a lot of well-examined and less highlighted predictors could be identified. Copyright (c) 2008 S. Karger AG, Basel.