Abstract
Background
We aimed to describe longitudinal patterns of care in community-dwelling European
patients with Alzheimer disease (AD), and determine patient-, caregiver-, and country-related
predictors of transitions across different care levels.
Methods
Two-year follow-up data from ICTUS cohort (1375 patients with AD, 12 countries) were
analyzed using multistate Markov models to describe transitions across states of care
and identify their predictors.
Results
Of the patients, 61.3% stayed in the same state during follow-up, and only 9.5% experienced
≥2 changes between states. Six-month transition probabilities were 11% for informal
to formal care and 13% for formal to informal care (in the community). Older age,
male gender, poorer cognitive and behavioral scores, and country of residence were
associated with transitioning from informal to formal care, but only country of residence
was associated with the reverse transition.
Discussion
Changes between different types of care were rare during follow-up, and country factors
in particular influenced these transitions.
Keywords
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Article info
Footnotes
N.C. and A.G. contributed equally to this work.
The Impact of Cholinergic Treatment Use/Data Sharing Alzheimer (ICTUS/DSA) group members are listed in the Appendix.
The authors declare no conflicts of interest.
No funding was received for this specific analysis. The ICTUS study was partially supported by a grant from the European Commission within the fifth framework programme (grant number QLK6-CT-2002–02645) and partially from an unrestricted equal grant from each of Eisai, Janssen, Lundbeck, and Novartis pharmaceutical companies. The pharmaceutical companies had no role in study design, data collection, data analysis, data interpretation. Promotion of the ICTUS study was supported by the University Hospital Centre of Toulouse. The data sharing activity was supported by the “Association Monegasque pour la recherche sur la maladie d’Alzheimer” (AMPA) and the INSERM – University of Toulouse III UMR 1027 research Unit.
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© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
