Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
systematic review of observational (cohort and case-control) studies
PubMed 27806743 · doi:10.1017/S1041610216001654
What was done
A systematic review and meta-analysis of controlled comparison studies assessing risk factors for nursing home admission among older adults with dementia. Across 26 included studies (17 cohort and 9 case-control), qualitative and quantitative analyses were performed, including meta-analyses of 15 studies.
What was found
The abstract reports no numerical effect sizes, odds ratios, or confidence intervals. Poorer cognition, behavioral and psychological symptoms of dementia, impaired activities of daily living, and caregiver burden were consistently associated with increased risk of nursing home admission. Findings were variable or unclear for caregiver depression and community support service usage, with some studies identifying increased risk following hip fracture, reduced mobility, and multiple comorbidities.
Why it matters
This review identifies core clinical and social factors driving nursing home entry in dementia, highlighting behavioral symptoms, cognitive and functional decline, and caregiver strain as primary intervention targets.
Limits
No numerical estimates or confidence intervals are reported in the abstract. Included evidence is limited to observational designs (cohort and case-control studies) susceptible to residual confounding, and evidence for community service use and caregiver depression was inconsistent.
Cited by
- contradicts The inability to get up and down off the ground independently is the number one reason people end up in nursing homes.