Living Alone with Alzheimer's Disease and the Risk of Adverse Outcomes: Results from the Plan de Soin et d'Aide dans la maladie d'Alzheimer Study

Publisher： John Wiley & Sons Inc

E-ISSN： 1532-5415|63|4|651-658

ISSN： 0002-8614

Source： JOURNAL OF AMERICAN GERIATRICS SOCIETY, Vol.63, Iss.4, 2015-04, pp. : 651-658

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Abstract

ObjectivesTo examine whether living alone predicted hospitalizations, nursing home admission, weight loss, and death in individuals with mild to moderate Alzheimer's disease (AD) over 2 years of follow‐up.DesignData are from the Plan de Soin et d'Aide dans la maladie d'Alzheimer study, a 24‐month trial with a cluster randomization of memory clinics in two arms: a multidomain intervention and usual care.SettingMemory clinics in France (N = 50).ParticipantsCommunity‐dwelling individuals with AD with a Mini‐Mental State Examination score between 12 and 26 and an identified caregiver.MeasurementsA neurogeriatric evaluation was conducted twice a year in the intervention group and annually in the control group. Hospitalizations, nursing home admission, weight loss, and death occurring during the past year were recorded. Information on sociodemographic characteristics, clinical conditions, therapy, and physical and cognitive status was recorded.ResultsAt inclusion, 348 (30.8%) of the 1,131 participants lived alone. Living alone did not increase the risk of mortality or weight loss in individuals with mild to moderate AD, but significant associations with risk of hospitalization (hazard ratio (HR) = 1.33, 95% confidence interval (CI) = 1.01–1.74) and institutionalization (HR = 2.53, 95% CI = 1.84–3.47) were reported. A protective effect of physical function on institutionalization and mortality was found.ConclusionThese results might support clinicians in making decisions about institutionalization of individuals with AD living alone or improving home health care, such as increasing screening and managing functional impairment in this complex population.