Department of Geriatrics, CHU Lille, Lille, France.
Department of METRICS, ULR 2694, Évaluation des technologies de santé et des pratiques médicales, Université of Lille., Lille, France.
J Am Geriatr Soc. 2021 Aug;69(8):2290-2297. doi: 10.1111/jgs.17207. Epub 2021 May 6.
The institutionalization of a patient with Alzheimer's disease or other dementia (ADOD) is the last resort for the latter's family and/or caregivers. We hypothesized that the degree of kinship between the patient and his/her caregiver would influence the likelihood of institutionalization.
To assess the association between institutionalization of patients with ADOD and the degree of kinship with the family caregiver.
A cross-sectional study of patients with ADOD aged 75 or over attending a memory center in France for the first time between 2011 and 2014, as recorded in the French National Alzheimer Database. Multivariable logistic regression was used to assess factors associated with institutionalization after adjustment for age, sex, the Mini-Mental State Examination score, educational level, and type of dementia.
A total of 52,874 patients were included. The primary caregiver was most often a child (54.8%) or the spouse (36.7%). Compared with the "spouse" reference category, all the other caregiver categories were associated with a significantly greater likelihood of institutionalization; the odds ratio [95% confidence interval] was 4.68 [3.67-5.92] when the carer was a grandchild, 5.48 [4.93-6.09] for a child, 4.93 [4.11-5.91] for a daughter-/son-in-law, 8.76 [7.15-10.70] for a sibling, and 8.93 [7.48-10.65] for a niece/nephew.
The likelihood of institutionalization of older patients with ADOD varied with the degree of kinship. Compared with the "spouse" reference category, the likelihood was higher for all other types of caregivers but was especially high when the caregiver was not a direct descendant of the patient.
对于阿尔茨海默病或其他痴呆症（ADOD）患者的家庭和/或护理人员来说，将患者送进疗养院是最后的选择。我们假设患者与其护理人员之间的亲属关系程度会影响其被送进疗养院的可能性。
评估 ADOD 患者被送进疗养院的可能性与他们与家庭护理人员之间亲属关系程度之间的关系。
这是一项在法国进行的横断面研究，研究对象为 2011 年至 2014 年间首次到法国记忆中心就诊的年龄在 75 岁及以上的 ADOD 患者，这些数据均记录在法国国家阿尔茨海默病数据库中。多变量逻辑回归用于评估在调整年龄、性别、简易精神状态检查评分、教育程度和痴呆类型后与被送进疗养院相关的因素。
共纳入 52874 例患者。主要护理人员通常是子女（54.8%）或配偶（36.7%）。与“配偶”参考类别相比，所有其他护理人员类别都与被送进疗养院的可能性显著增加相关；当护理人员是孙子女/外孙子女时，比值比[95%置信区间]为 4.68[3.67-5.92]，当护理人员是子女时，比值比为 5.48[4.93-6.09]，当护理人员是女婿/儿媳/儿子/儿媳时，比值比为 4.93[4.11-5.91]，当护理人员是兄弟姐妹时，比值比为 8.76[7.15-10.70]，当护理人员是侄子/侄女时，比值比为 8.93[7.48-10.65]。
ADOD 老年患者被送进疗养院的可能性因亲属关系程度而异。与“配偶”参考类别相比，所有其他类型的护理人员的可能性更高，但当护理人员不是患者的直系亲属时，这种可能性尤其高。
