Wang J J, Mitchell P, Smith W, Cumming R G, Leeder S R
Department of Ophthalmology, Save Sight Institute, University of Sydney, Westmead, NSW, Australia.
Med J Aust. 2001 Mar 19;174(6):271-5. doi: 10.5694/j.1326-5377.2001.tb143267.x.
To assess cumulative incidence and non-cognitive factors predicting nursing home placement in a defined older population.
Six-year follow-up of a population-based cohort living west of Sydney.
3654 non-institutionalised residents aged 49 years or older (82.4% of those eligible) participated in baseline examinations during 1992 to 1994.
Permanent nursing home admission for long-term institutionalised aged care in New South Wales, confirmed by records of approvals by the regional Aged Care Assessment Team and subsidy payments by government.
After excluding 384 participants who moved from the area or were lost to follow-up, 162 participants (5.0%) had been admitted to nursing homes on a permanent basis by October 1999. Of participants who died since baseline, 20% had been admitted to a nursing home before death. Of those alive, 1.6% were current nursing home residents. Six-year cumulative incidence rates for nursing home placement were 0.7%, 1.1%, 2.4%, 3.9%, 9.0%, 18.3% and 34.9% for people aged 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 and 85 years or older, respectively. Non-cognitive factors at baseline predicting subsequent nursing home admission included each additional year of age (risk ratio [RR], 1.14), fair or poor compared with excellent self-rated health (RR, 2.9, 3.6), walking difficulty (RR, 3.6) and current smoking (RR, 1.9). People owning their homes had a decreased likelihood of nursing home placement (RR, 0.6).
Incidence rates of institutional aged care doubled for each five-year interval from the age of 60 years. A range of non-cognitive factors predict nursing home placement.
评估特定老年人群中进入养老院的累积发病率及预测因素。
对悉尼西部以人群为基础的队列进行为期六年的随访。
1992年至1994年间，3654名年龄在49岁及以上的非机构化居民（占符合条件者的82.4%）参加了基线检查。
新南威尔士州长期机构化老年护理的永久性养老院入住情况，由地区老年护理评估小组的批准记录和政府补贴支付情况确认。
排除384名搬离该地区或失访的参与者后，到1999年10月，162名参与者（5.0%）已被永久性送入养老院。自基线以来死亡的参与者中，20%在死前已入住养老院。存活者中，1.6%为当前养老院居民。55 - 59岁、60 - 64岁、65 - 69岁、70 - 74岁、75 - 79岁、80 - 84岁和85岁及以上人群进入养老院的六年累积发病率分别为0.7%、1.1%、2.4%、3.9%、9.0%、18.3%和34.9%。基线时预测随后进入养老院的非认知因素包括每增加一岁（风险比[RR]，1.14）、自我评估健康状况为“一般”或“较差”与“优秀”相比（RR，2.9、3.6）、行走困难（RR，3.6）和当前吸烟（RR，1.9）。拥有自有住房的人进入养老院的可能性降低（RR，0.6）。
从60岁起，每五年机构化老年护理的发病率翻倍。一系列非认知因素可预测养老院入住情况。
