Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia
Factors predicting the early institutionalization of demented patients were studied in 143 outpatients using univariate and multivariate life-table methods. Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characte...
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| Veröffentlicht in: | Journal of geriatric psychiatry and neurology 1992-01, Vol.5 (1), p.45-52 |
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| container_title | Journal of geriatric psychiatry and neurology |
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| creator | O'Donnell, Brian F. Drachman, David A. Barnes, Heather J. Peterson, Karen E. Swearer, Joan M. Lew, Robert A. |
| description | Factors predicting the early institutionalization of demented patients were studied in 143 outpatients using univariate and multivariate life-table methods. Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characteristics, and type of caregiver. After follow-up of 19 ± 12 months, 51 patients had been institutionalized. Increased global severity of dementia, the presence of troublesome and disruptive behaviors, and incontinence increased the likelihood of institutionalization. The best predictors of institutionalization were paranoia, aggressive behavior, and incontinence. Neither individual patient characteristics (age, education, and gender) nor caregiver relationship to the patient (male spouse, female spouse, and male or female child) influenced institutionalization. Since troublesome behavioral disorders are potentially treatable aspects of dementia leading to institutionalization, their management should be a major focus of therapy in dementia. (J Geriatr Psychiatry Neurol 1992;5:45–52). |
| doi_str_mv | 10.1177/002383099200500108 |
| format | Article |
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Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characteristics, and type of caregiver. After follow-up of 19 ± 12 months, 51 patients had been institutionalized. Increased global severity of dementia, the presence of troublesome and disruptive behaviors, and incontinence increased the likelihood of institutionalization. The best predictors of institutionalization were paranoia, aggressive behavior, and incontinence. Neither individual patient characteristics (age, education, and gender) nor caregiver relationship to the patient (male spouse, female spouse, and male or female child) influenced institutionalization. Since troublesome behavioral disorders are potentially treatable aspects of dementia leading to institutionalization, their management should be a major focus of therapy in dementia. (J Geriatr Psychiatry Neurol 1992;5:45–52).</description><identifier>ISSN: 0891-9887</identifier><identifier>EISSN: 1552-5708</identifier><identifier>DOI: 10.1177/002383099200500108</identifier><identifier>PMID: 1571074</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Activities of Daily Living - psychology ; Aged ; Aggression - psychology ; Alzheimer Disease - epidemiology ; Alzheimer Disease - psychology ; Alzheimer Disease - therapy ; Biological and medical sciences ; Caregivers - psychology ; Fecal Incontinence - epidemiology ; Fecal Incontinence - psychology ; Fecal Incontinence - therapy ; Female ; Follow-Up Studies ; Geriatrics ; Humans ; Institutionalization - statistics & numerical data ; Life Tables ; Male ; Massachusetts - epidemiology ; Medical sciences ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. 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Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characteristics, and type of caregiver. After follow-up of 19 ± 12 months, 51 patients had been institutionalized. Increased global severity of dementia, the presence of troublesome and disruptive behaviors, and incontinence increased the likelihood of institutionalization. The best predictors of institutionalization were paranoia, aggressive behavior, and incontinence. Neither individual patient characteristics (age, education, and gender) nor caregiver relationship to the patient (male spouse, female spouse, and male or female child) influenced institutionalization. Since troublesome behavioral disorders are potentially treatable aspects of dementia leading to institutionalization, their management should be a major focus of therapy in dementia. (J Geriatr Psychiatry Neurol 1992;5:45–52).</description><subject>Activities of Daily Living - psychology</subject><subject>Aged</subject><subject>Aggression - psychology</subject><subject>Alzheimer Disease - epidemiology</subject><subject>Alzheimer Disease - psychology</subject><subject>Alzheimer Disease - therapy</subject><subject>Biological and medical sciences</subject><subject>Caregivers - psychology</subject><subject>Fecal Incontinence - epidemiology</subject><subject>Fecal Incontinence - psychology</subject><subject>Fecal Incontinence - therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Institutionalization - statistics & numerical data</subject><subject>Life Tables</subject><subject>Male</subject><subject>Massachusetts - epidemiology</subject><subject>Medical sciences</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. 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Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Social Behavior</topic><topic>Urinary Incontinence - epidemiology</topic><topic>Urinary Incontinence - psychology</topic><topic>Urinary Incontinence - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Donnell, Brian F.</creatorcontrib><creatorcontrib>Drachman, David A.</creatorcontrib><creatorcontrib>Barnes, Heather J.</creatorcontrib><creatorcontrib>Peterson, Karen E.</creatorcontrib><creatorcontrib>Swearer, Joan M.</creatorcontrib><creatorcontrib>Lew, Robert A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of geriatric psychiatry and neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Donnell, Brian F.</au><au>Drachman, David A.</au><au>Barnes, Heather J.</au><au>Peterson, Karen E.</au><au>Swearer, Joan M.</au><au>Lew, Robert A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia</atitle><jtitle>Journal of geriatric psychiatry and neurology</jtitle><addtitle>J Geriatr Psychiatry Neurol</addtitle><date>1992-01</date><risdate>1992</risdate><volume>5</volume><issue>1</issue><spage>45</spage><epage>52</epage><pages>45-52</pages><issn>0891-9887</issn><eissn>1552-5708</eissn><abstract>Factors predicting the early institutionalization of demented patients were studied in 143 outpatients using univariate and multivariate life-table methods. Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characteristics, and type of caregiver. After follow-up of 19 ± 12 months, 51 patients had been institutionalized. Increased global severity of dementia, the presence of troublesome and disruptive behaviors, and incontinence increased the likelihood of institutionalization. The best predictors of institutionalization were paranoia, aggressive behavior, and incontinence. Neither individual patient characteristics (age, education, and gender) nor caregiver relationship to the patient (male spouse, female spouse, and male or female child) influenced institutionalization. Since troublesome behavioral disorders are potentially treatable aspects of dementia leading to institutionalization, their management should be a major focus of therapy in dementia. 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| subjects | Activities of Daily Living - psychology Aged Aggression - psychology Alzheimer Disease - epidemiology Alzheimer Disease - psychology Alzheimer Disease - therapy Biological and medical sciences Caregivers - psychology Fecal Incontinence - epidemiology Fecal Incontinence - psychology Fecal Incontinence - therapy Female Follow-Up Studies Geriatrics Humans Institutionalization - statistics & numerical data Life Tables Male Massachusetts - epidemiology Medical sciences Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Social Behavior Urinary Incontinence - epidemiology Urinary Incontinence - psychology Urinary Incontinence - therapy |
| title | Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia |
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