Salminen Marika, Vire Jenni, Viikari Laura, Vahlberg Tero, Isoaho Hannu, Lehtonen Aapo, Viitanen Matti, Arve Seija, Eloranta Sini
Unit of Family Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, 20014, Turku, Finland.
City of Turku, Welfare division, Yliopistonkatu 30, Turku, Finland.
Aging Clin Exp Res. 2017 Jun;29(3):499-505. doi: 10.1007/s40520-016-0722-3. Epub 2017 Feb 17.
Identification of predictive factors on institutionalization provides the basis for the development and application of preadmission assessment. There is a lack of evidence for predictors of institutionalization for older people.
To examine the effect of predictive factors on institutionalization in home-dwelling 70-year-old people.
The data were collected in 1991 by the clinical examinations, a postal questionnaire, and an interview from the residents of Turku, Finland, born in 1920 (n = 1032). Institutionalization was defined as entry into a nursing home or sheltered housing at any time during a 22-year follow-up.
A rate of institutionalization was 22.0%. In multivariable Cox regression analysis, impaired cognitive function (MMSE 18-26) (hazard ratio 1.71, confidence interval 1.24-2.36) and low BMI (<25 kg/m) (compared to both BMI of 25-29.9 and that of ≥30, respectively, 1.88, 1.32-2.67, and 1.66, 1.05-2.60), having several falls during the previous year (2.50, 1.28-4.90).
We conclude that impaired cognitive function, low BMI, and frequent falling predicted institutionalization during the 22-year follow-up. To reduce or postpone institutionalization, interventions should target risk factors, such as frailty, physical limitations, and falling. In addition, community-based services according to the needs and functional ability of the home-dwelling older people should be developed.
确定机构养老的预测因素可为入院前评估的开展和应用提供依据。目前缺乏关于老年人机构养老预测因素的证据。
研究预测因素对70岁居家老人机构养老的影响。
1991年通过临床检查、邮寄问卷和访谈收集了芬兰图尔库1920年出生的居民（n = 1032）的数据。机构养老定义为在22年随访期间的任何时间入住养老院或庇护性住房。
机构养老率为22.0%。在多变量Cox回归分析中，认知功能受损（MMSE 18 - 26）（风险比1.71，置信区间1.24 - 2.36）、低体重指数（<25 kg/m²）（与体重指数为25 - 29.9及≥30相比，分别为1.88，1.32 - 2.67和1.66，1.05 - 2.60）、前一年有多次跌倒（2.50，1.28 - 4.90）。
我们得出结论，在22年的随访中，认知功能受损、低体重指数和频繁跌倒可预测机构养老情况。为减少或推迟机构养老，干预措施应针对诸如虚弱、身体限制和跌倒等风险因素。此外，应根据居家老年人的需求和功能能力发展社区服务。
