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Caregiving and institutionalization of cognitively impaired older people: utilizing dynamic predictors of change
Gaugler JE, Kane RL, Kane RA, Clay T, Newcomer R.. The Gerontologist, 2003-04-01
Topic: Risk, prevention and care in population studies
Purpose The purpose of this study was to identify reliable predictors of nursing home entry over a 3-year period in a sample of 3,944 persons with dementia who resided in a home setting at baseline. Strengths of the analysis include a multiregional recruitment strategy, incorporation of salient caregiver characteristics, and a 3-year prospective design that allows for the modeling of change in important variables (e.g., care recipient functional status or caregiving indicators) when time to institutionalization is predicted. Design and methods Data were derived from the control sample of the Medicare Alzheimer's Disease Demonstration Evaluation (MADDE). A Cox proportional hazards model was used to predict time to institutionalization among individuals with dementia (baseline was enrollment into MADDE). Predictors included care recipient demographics, caregiver demographics, and time-varying measurements of care recipient functional status, caregiving indicators, and service utilization. Indicators of change were also incorporated to capitalize on the prospective data available. Results Although several results were consistent with prior findings, caregiving indicators (i.e., burden and self-rated health) and community-based service use were significant predictors of earlier placement. Change in caregiver instrumental activities of daily living and care recipient activities of daily living were also related to expedited institutionalization. Implications The findings emphasize the importance of incorporating both care recipient and caregiver function and service use patterns when targeting programs designed to prevent or delay institutionalization for people with dementia.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Gaugler, J. E., Kane, R. L., Kane, R. A., Clay, T., & Newcomer, R. (2003). Caregiving and institutionalization of cognitively impaired older people: utilizing dynamic predictors of change. The Gerontologist. https://doi.org/10.1093/geront/43.2.219
Vancouver
Gaugler JE, Kane RL, Kane RA, Clay T, Newcomer R. Caregiving and institutionalization of cognitively impaired older people: utilizing dynamic predictors of change. The Gerontologist. 2003. doi:10.1093/geront/43.2.219. PMID: 12677079.
BibTeX
@article{gaugler2003-12677079,
author = {Gaugler, J. E. and Kane, R. L. and Kane, R. A. and Clay, T. and Newcomer, R.},
title = {{Caregiving and institutionalization of cognitively impaired older people: utilizing dynamic predictors of change}},
journal = {The Gerontologist},
year = {2003},
doi = {10.1093/geront/43.2.219},
pmid = {12677079},
url = {https://doi.org/10.1093/geront/43.2.219}
}
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Key findings
- Results Although several results were consistent with prior findings, caregiving indicators (i.e., burden and self-rated health) and community-based service use were significant predictors of earlier placement.
Why it matters
This study of people with dementia living at home found that caregiver burden, caregiver self-rated health, and use of community-based services predicted earlier placement in a nursing home. It did not test any treatment or cure for dementia itself.
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Study details
- Participants3,944
- Evidence strengthLow
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Gerontologist) |
| Journal's citation record | 2 / 4 | The Gerontologist: journal h-index 238 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 3 / 4 | 3,944 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 254 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.2 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 3 / 6 | Cited 7.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 2 / 4 | Cited 16 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Robert J. Newcomer: h-index 28 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12677079) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 49 / 100 | — |
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