PLoS ONE
Volume 7, Issue 9, 2012

Mild Cognitive Impairment Predicts Institutionalization among Older Men: A Population-Based Cohort Study (Article) (Open Access)

Gnjidic D.* , Stanaway F.F. , Cumming R. , Waite L. , Blyth F. , Naganathan V. , Handelsman D.J. , Le Couteur D.G.
  • a Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, NSW, Australia, Sydney Medical School, University of Sydney, Sydney, NSW, Australia, Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia, Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
  • b Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia, Sydney School of Public Health, University of Sydney, Sydney NSW, Australia
  • c Sydney Medical School, University of Sydney, Sydney, NSW, Australia, Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia, Sydney School of Public Health, University of Sydney, Sydney NSW, Australia
  • d Sydney Medical School, University of Sydney, Sydney, NSW, Australia, Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia
  • e Sydney Medical School, University of Sydney, Sydney, NSW, Australia, Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia
  • f Sydney Medical School, University of Sydney, Sydney, NSW, Australia, Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia
  • g Sydney Medical School, University of Sydney, Sydney, NSW, Australia, ANZAC Research Institute, Concord Hospital, Sydney, NSW, Australia
  • h Sydney Medical School, University of Sydney, Sydney, NSW, Australia, Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia, ANZAC Research Institute, Concord Hospital, Sydney, NSW, Australia

Abstract

Background: There is a lack of evidence on the contribution of mild cognitive impairment (MCI) to institutionalization in older adults. This study aimed to evaluate a range of risk factors including MCI of institutionalization in older men. Methods: Men aged ≥70 years (n = 1705), participating in the Concord Health and Ageing in Men Project, Sydney, Australia were studied. Participants completed self-reported questionnaires and underwent comprehensive clinical assessments during 2005-2007. Institutionalization was defined as entry into a nursing home facility or hostel at any time over an average of 5 years of follow-up. Cox regression analysis was conducted to generate hazard ratios (HR) with 95% confidence intervals (CI). Results: A total of 125 (7.3%) participants were institutionalized. Piecewise Cox proportional models were generated and divided at 3.4 years (1250 days) of follow-up due to violation of the proportional hazards assumption for the association between MCI and institutionalization (χ2 = 6.44, p = 0.01). Dementia, disability in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), poor grip strength, few social interactions, being a Non-English speaking immigrant and age were predictive of institutionalization during both time periods, whereas MCI (HR = 4.39, 95%CI 2.17-8.87) only predicted institutionalization in the period beyond 3.4 years of follow-up. Being married (HR = 0.42, 95%CI: 0.24-0.72) was protective only during the period after 3.4 years of follow-up. Discussion: In this study, the strongest predictors of institutionalization were dementia, MCI, ADL and IADL disability. MCI was not a predictor of early institutionalization but became a significant predictor beyond 3.4 years of follow-up. © 2012 Gnjidic et al.

Author Keywords

[No Keywords available]

Index Keywords

prospective study institutionalization immigrant grip strength Australia home care demography Dementia predictive value Follow-Up Studies follow up human anxiolytic agent Self Report daily life activity clinical assessment risk assessment Cohort Studies Activities of Daily Living health status Aged social interaction hazard ratio men's health predictor variable Confidence interval social status Humans nursing home male Aged, 80 and over ADL disability risk factor IADL disability anticonvulsive agent population research neurologic examination mild cognitive impairment Article health care utilization major clinical study age Age Factors outcome variable disability community living Models, Statistical cohort analysis neuroleptic agent psychotropic agent health hazard antidepressant agent physical performance elderly care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84866698595&doi=10.1371%2fjournal.pone.0046061&partnerID=40&md5=c59c131dd24bd63fda2be17ebeeb8779
DOI: 10.1371/journal.pone.0046061
ISSN: 19326203
Cited by: 24
Original Language: English