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. 2021 Apr;36(4):511-520.
doi: 10.1002/gps.5446. Epub 2020 Oct 19.

Socio-economic predictors of time to care home admission in people living with dementia in Wales: A routine data linkage study

Clarissa Giebel  1   2 , Joe Hollinghurst  3 , Ashley Akbari  3   4   5 , Christian Schnier  5   6 , Tim Wilkinson  5   6   7 , Laura North  3   5 , Mark Gabbay  1   2 , Sarah Rodgers  1   2
Affiliations

Socio-economic predictors of time to care home admission in people living with dementia in Wales: A routine data linkage study

Clarissa Giebel et al. Int J Geriatr Psychiatry. 2021 Apr.

Abstract

Objectives: Limited research has shown that people with dementia (PwD) from lower socio-economic backgrounds can face difficulties in accessing the right care at the right time. This study examined whether socio-economic status (SES) and rural versus urban living location are associated with the time between diagnosis and care home admission in PwD living in Wales, UK.

Methods/design: This study linked routine health data and an e-cohort of PwD who have been admitted into a care home between 2000 and 2018 living in Wales. Survival analysis explored the effects of SES, living location, living situation, and frailty on the time between diagnosis and care home admission.

Results: In 34,514 PwD, the average time between diagnosis and care home admission was 1.5 (±1.4) years. Cox regression analysis showed that increased age, living alone, frailty, and living in less disadvantaged neighbourhoods were associated with faster rate to care home admission. Living in rural regions predicted a slower rate until care home admission.

Conclusions: This is one of the first studies to show a link between socio-economic factors on time to care home admission in dementia. Future research needs to address variations in care needs between PwD from different socio-economic and geographical backgrounds.

Keywords: care homes; dementia; health inequalities; routine data; socio-economic status.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Flow diagram of sample selection
FIGURE 2
FIGURE 2
Time between diagnosis and care home admission by Welsh Index of Multiple Deprivation (WIMD) Quintile. Y‐axis shows the length in time in years between dementia diagnosis and care home admission
FIGURE 3
FIGURE 3
Time between diagnosis and care home admission by rural/urban indicator. Y‐axis shows the length in time in years between dementia diagnosis and care home admission
FIGURE 4
FIGURE 4
Kaplan–Meier survival curves for time until care home admission by Welsh Index of Multiple Deprivation (WIMD) Quintiles (A) and rural versus urban living location (B). X‐axis shows the length in time in years between dementia diagnosis and care home admission. Y‐axis shows the cumulative survival rate in the first 12 months since diagnosis
See this image and copyright information in PMC

References

    1. Alzheimer's Disease International (ADI) . World Alzheimer Report 2016. London, England: ADI; 2016.
    1. Prince M, Knapp M, Guerchet M, et al. Dementia UK: Update. Alzheimer's Society; 2014.
    1. Wuebker A, Zwakhalen SMG, Challis D, et al. Costs of care for people with dementia just before and after nursing home placement: primary data from eight European countries. Euro J Health Econ. 2015;16(7):689‐707. - PubMed
    1. Romeo R, Knapp M, Salverda S, et al. The cost of care homes for people with dementia in England: a modelling approach. Int J Geriatric Psychiatry. 2017;32(12):1466‐1475. - PubMed
    1. Giebel CM, Sutcliffe C, Challis D. Hierarchical decline of the initiative and performance of complex activities of daily living in dementia. J Geriatr Psychiatr Neurol. 2017;30(2):96‐103. - PubMed

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