Institutionalization in Cognitively-Impaired Older Individuals

Older adults with cognitive impairment are often institutionalized. Many cross-sectional studies have identified factors associated with this outcome but there is a paucity of longitudinal studies examining if progression of the condition is associated with institutionalization. In this study we followed 30 older adults with cognitive impairment for an average of three years. One third of these individuals were institutionalized by the end of the follow up period. The only factor significantly associated with institutionalization was the relationship of the caregivers to the care recipients. Individuals cared for by non-spousal caregivers were more likely to be institutionalized and also more likely to be institutionalized earlier than individuals cared for by their spouses. These results suggest that social factors are more important determinants of institutionalization than the functional status of the care recipients. A better understanding of these social factors is required to develop support resources for caregivers.