School of Health Sciences, University of Tampere, Tampere FIN-33014, Finland.
Age Ageing. 2012 Jan;41(1):52-7. doi: 10.1093/ageing/afr133. Epub 2011 Nov 16.
Dementia is one of the main challenges to our health and social care. This study compares the number and timing of transitions between care settings in the last 2 years of life among older people with and without dementia.
Data were derived from Finnish national registers, and include all those who died in 2002 and 2003 at the age of 70 or older (n = 70,366). Negative binomial regression analyses were used to analyse the impact of dementia on number of transitions among people with and without dementia and to adjust the number for age, gender and other diagnoses.
In the group that lived at home 2 years before death people with a dementia diagnosis had 32% more care transitions than people without dementia, while the group that was in residential care facility 2 years before death people with dementia had 12% fewer moves than those without dementia The average number of transition was highest in last 3 months of life. People with dementia had their last move more often between care facilities and hospitals offering basic health care than people without dementia.
Dementia has a significant impact on the number and type of transitions. As the number of people with dementia increases, the quality and equity of care of these patients in their last years constitute a special challenge.
痴呆症是对我们的健康和社会护理的主要挑战之一。本研究比较了在生命的最后 2 年中患有痴呆症和不患有痴呆症的老年人之间在护理环境中过渡的数量和时间。
数据来自芬兰国家登记处，包括所有在 2002 年和 2003 年 70 岁或以上死亡的人（n=70366）。使用负二项回归分析来分析痴呆症对患有和不患有痴呆症的人过渡次数的影响，并根据年龄、性别和其他诊断调整人数。
在生命的最后 2 年住在家里的人群中，患有痴呆症诊断的人比没有痴呆症的人多 32%的护理过渡，而在生命的最后 2 年住在养老院的人群中，患有痴呆症的人比没有痴呆症的人少 12%的转移。过渡的平均数量在生命的最后 3 个月最高。患有痴呆症的人比没有痴呆症的人更经常在护理设施和提供基本医疗保健的医院之间进行最后的转移。
痴呆症对数量和类型的转移有重大影响。随着痴呆症患者人数的增加，这些患者在生命的最后几年中的护理质量和公平性构成了一个特殊的挑战。
