Early start of anti-dementia medication delays transition to 24-hour care in Alzheimer's disease patients: A Finnish nationwide cohort study
O Halminen, A Vesikansa, J Mehtälä… - Journal of …, 2021 - content.iospress.com
O Halminen, A Vesikansa, J Mehtälä, I Hörhammer, T Mikkola, LJ Virta, T Ylisaukko-Oja…
Journal of Alzheimer's Disease, 2021•content.iospress.comBackground: Dementia is one of the strongest predictors of admission to a 24-hour care
facility among older people, and 24-hour care is the major cost of Alzheimer's disease (AD).
Objective: The aim of this study was to evaluate the association of early start of anti-
dementia medication and other predisposing factors with 2-year risk of transition to 24-hour
care in the nationwide cohort of Finnish AD patients. Methods: This was a retrospective, non-
interventional study based on individual-level data from Finnish national health and social …
facility among older people, and 24-hour care is the major cost of Alzheimer's disease (AD).
Objective: The aim of this study was to evaluate the association of early start of anti-
dementia medication and other predisposing factors with 2-year risk of transition to 24-hour
care in the nationwide cohort of Finnish AD patients. Methods: This was a retrospective, non-
interventional study based on individual-level data from Finnish national health and social …
Abstract
Background:
Dementia is one of the strongest predictors of admission to a 24-hour care facility among older people, and 24-hour care is the major cost of Alzheimer’s disease (AD).
Objective:
The aim of this study was to evaluate the association of early start of anti-dementia medication and other predisposing factors with 2-year risk of transition to 24-hour care in the nationwide cohort of Finnish AD patients.
Methods:
This was a retrospective, non-interventional study based on individual-level data from Finnish national health and social care registers. The incident cohort included 7,454 AD patients (ICD-10, G30) comprised of two subgroups: those living unassisted at home (n= 5,002), and those receiving professional home care (n= 2,452). The primary outcome was admission to a 24-hour care facility. Exploratory variables were early versus late anti-dementia medication start, sociodemographic variables, care intensity level, and comorbidities.
Results:
Early anti-dementia medication reduced the risk of admission to 24-hour care both in patients living unassisted at home, with a hazard ratio (HR) of 0.58 (p< 0.001), and those receiving professional home care (HR, 0.84; p= 0.039). Being unmarried (HR, 1.69; p< 0.001), having an informal caregiver (HR, 1.69; p= 0.003), or having a diagnosis of additional neurological disorder (HR, 1.68; p= 0.006) or hip fracture (HR, 1.61; p= 0.004) were associated with higher risk of admission to 24-hour care in patients living unassisted at home.
Conclusion:
To support living at home, early start of anti-dementia medication should be a high priority in newly diagnosed AD patients.
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