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Abstract

Background: Dependency is simultaneously associated with physical functioning, cognition and behavior, so it might be a simple measure to explain the progression of dementia and institutionalization. Objectives: To investigate the association between physical dependency and the presence of neuropsychiatric symptoms with the admission of people with dementia to a long-term care institution (LTCI). Methods: A prospective observational cohort study with people with dementia (PwD) living at home but at risk of institutionalization and their caregivers, in eight European countries. Baseline and 3-month follow-up interviews were performed between November, 2010 and April, 2012. The sample comprised 116 PwD recently admitted to LTCI and 949 PwD living at home. Physical dependency measured by Katz index of Activity of Daily Living (ADL) dimensions� and neuropsychiatric symptoms measured by The Neuropsychiatric Inventory dimensions� were analyzed by performing logistic regression analysis with the group categories. This logistic regression analysis was performed after considering baseline characteristics to define physical dependency associate factors related to the institutionalization, and follow-up characteristics to detect changes in physical dependency and neuropsychiatric symptoms associated with being admitted to a LTCI. Results: Toileting, dressing and continence dependency was higher in LTCI compared to HC. Delusion, hallucination, agitation, anxiety, apathy, motor-disturbances, nighttime-behavior and eating disorders were poorer in LTCI than HC. Conclusions: This study supports the association between PwDs� physical level of dependence and the long-term institutionalization. Living as PwD in LTCI is associated with physical dependency and presence of neuropsychiatric symptoms. Additional results showed that these symptoms improved after institutionalization.

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