Home › Research › Caregiving
Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging
Hébert R, Dubois MF, Wolfson C, Chambers L, Cohen C.. The journals of gerontology. Series A, Biological sciences and medical sciences, 2001-11-01
Topic: Risk, prevention and care in population studies
Background In Canada, half the people with dementia live in institutions. Factors associated with institutionalization should be identified with the goal of implementing strategies not only to permit those with dementia to stay in their homes as long as is feasible but also to ensure that steps are taken for timely institutionalization when appropriate. Methods Informal caregivers of 326 individuals with dementia living in the community were identified and interviewed as part of the Canadian Study of Health and Aging (CSHA). These subjects were contacted again 2.5 and 5 years after the baseline interview to collect information on the status of their care recipients. Survival analyses using clinical data for the individuals with dementia and data from the interviews with their informal caregivers were carried out using Cox proportional hazard modeling to estimate the hazard ratio (HR). Results Over the 5-year period, 166 individuals with dementia (50.9%) were institutionalized and the median time to admission was 41 months. From the multivariate analysis, the factors significantly associated with institutionalization were: type of dementia (Alzheimer's disease: HR = 1.83), severity of disability (mild: 1.51; moderate: 2.34; total impairment: 4.02), caregiver's age over 60 (1.83), caregiver not a spouse or child (1.55), and severe caregiver burden (1.71). Caregiver's burden was associated with the care-receiver's behavioral disturbance (partial r =.55) and the caregiver's depressive mood (r =.55). Conclusions Screening caregivers for burden and depression and designing interventions to decrease the consequences of behavioral disturbance on caregivers would be relevant avenues to explore to decrease institutionalization of people with dementia.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Hébert, R., Dubois, M. F., Wolfson, C., Chambers, L., & Cohen, C. (2001). Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging. The journals of gerontology. Series A, Biological sciences and medical sciences. https://doi.org/10.1093/gerona/56.11.m693
Vancouver
Hébert R, Dubois MF, Wolfson C, Chambers L, Cohen C. Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging. The journals of gerontology. Series A, Biological sciences and medical sciences. 2001. doi:10.1093/gerona/56.11.m693. PMID: 11682577.
BibTeX
@article{hebert2001-11682577,
author = {Hébert, R. and Dubois, M. F. and Wolfson, C. and Chambers, L. and Cohen, C.},
title = {{Factors associated with long-term institutionalization of older people with dementia: data from the Canadian Study of Health and Aging}},
journal = {The journals of gerontology. Series A, Biological sciences and medical sciences},
year = {2001},
doi = {10.1093/gerona/56.11.m693},
pmid = {11682577},
url = {https://doi.org/10.1093/gerona/56.11.m693}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Factors associated with institutionalization should be identified with the goal of implementing strategies not only to permit those with dementia to stay in their homes as long as is feasible but also to ensure that steps are taken for timely institutionalization when appropriate.
- Results Over the 5-year period, 166 individuals with dementia (50.9%) were institutionalized and the median time to admission was 41 months.
- From the multivariate analysis, the factors significantly associated with institutionalization were: type of dementia (Alzheimer's disease: HR = 1.83), severity of disability (mild: 1.51; moderate: 2.34; total impairment: 4.02), caregiver's age over 60 (1.83), caregiver not a spouse or child (1.55), and severe caregiver burden (1.71).
- Caregiver's burden was associated with the care-receiver's behavioral disturbance (partial r =.55) and the caregiver's depressive mood (r =.55).
Why it matters
In a Canadian study following 326 people with dementia living at home, about half (50.9%) moved into long-term care within five years, after a median of 41 months. Moves were more likely with greater disability, an Alzheimer's diagnosis, a caregiver over 60 or one who was not a spouse or child, and severe caregiver burden. Burden itself tracked the person's behavioural symptoms and the caregiver's low mood. These are associations, not proven causes, but the authors suggest screening caregivers for burden and depression as an avenue to explore.
New to this subject? Start with our plain-English guide: Caregiving →
Study details
- Participants326
- Effect size50.9%; HR = 1.83
- Evidence strengthLow
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 48 of the 97 points we could judge it on, which is 49 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The journals of gerontology. Series A, Biological sciences and medical sciences) |
| Journal's citation record | 3 / 4 | The Journals of Gerontology Series A: journal h-index 274 (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 | 2001 — older than 20 years, still counted |
| Sample size | 2 / 4 | 326 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 260 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.6 citations a year over 27 year(s) since 2001 |
| Impact for its field and year | 3 / 6 | Cited 5.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 9 other studies in this library |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Carole A. Cohen: h-index 26 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11682577) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 48 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 48 of the 97 points we could judge it on is 49 out of 100. |
| Total | 49 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
9 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Caregiving
Also tagged “care”
996 studies in the library carry the topic tag “care”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 996 tagged studies.