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Time until institutionalization and death in patients with dementia. Role of caregiver training and risk factors
Brodaty H, McGilchrist C, Harris L, Peters KE.. Archives of neurology, 1993-06-01
Topic: Risk, prevention and care in population studies
Objective To determine which variables best predict prognosis--time to nursing home admission (NHA) and death--in patients with dementia. Design Survival analysis employing the Cox proportional hazards model with the use of risk variables pertaining to dementia severity and its rate of progression and caregiver functioning. Setting Patients and their caregivers participating in a controlled intervention study of training for caregivers in home management of dementia. Participants Patients with mild Diagnostic and Statistical Manual of Mental Disorders, Third Edition--defined dementia (N = 91; 68 patients with Alzheimer-type dementia, 20 with vascular dementia, and three with other types) and their caregivers. Follow-up All subjects had repeated assessments in the first year to determine rates of change and thereafter annually to determine the date of NHA and/or death. RISK VARIABLES: (1) Caregiver training; (2) dementia severity at index assessment; (3) caregiver stress, neuroticism, and socialization; (4) changes in patients and caregivers during the first 12 months; and (5) patient characteristics. Results By 5 years' follow-up, 76% of patients had entered a nursing home and 42% had died. Dementia severity and rate of deterioration ("how far" and "how fast") and caregiver psychological morbidity significantly influenced rates of NHA and death. Training of caregivers was significantly associated with delayed NHA and reduced mortality. Greater patient age, non-Alzheimer's dementia, and, unexpectedly, greater caregiver psychological morbidity were associated with shorter survival to death. Conclusions Both severity ("how far") and rate of deterioration ("how fast") influence time to NHA and death. Caregiver training may have important ameliorating effects on the prognosis of dementia.
Key findings
- Results By 5 years' follow-up, 76% of patients had entered a nursing home and 42% had died.
- Dementia severity and rate of deterioration ("how far" and "how fast") and caregiver psychological morbidity significantly influenced rates of NHA and death.
- Training of caregivers was significantly associated with delayed NHA and reduced mortality.
- Greater patient age, non-Alzheimer's dementia, and, unexpectedly, greater caregiver psychological morbidity were associated with shorter survival to death.
Why it matters
This study found that dementia severity, rate of deterioration, and caregiver psychological morbidity significantly influenced rates of nursing home admission and death. Training of caregivers was significantly associated with delayed nursing home admission and reduced mortality.
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Study details
- Participants91
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | 3 / 4 | Archives of Neurology: journal h-index 353 (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 | 1993 — older than 20 years, still counted |
| Sample size | 1 / 4 | 91 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 223 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.4 citations a year over 35 year(s) since 1993 |
| Impact for its field and year | 3 / 6 | Cited 4.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 16 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Henry Brodaty: h-index 127 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | UNSW Sydney: institution h-index 1,101 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 8503802) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 47 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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.
APA 7th
Brodaty, H., McGilchrist, C., Harris, L., & Peters, K. E. (1993). Time until institutionalization and death in patients with dementia. Role of caregiver training and risk factors. Archives of neurology. https://doi.org/10.1001/archneur.1993.00540060073021
Vancouver
Brodaty H, McGilchrist C, Harris L, Peters KE. Time until institutionalization and death in patients with dementia. Role of caregiver training and risk factors. Archives of neurology. 1993. doi:10.1001/archneur.1993.00540060073021. PMID: 8503802.
BibTeX
@article{brodaty1993-8503802,
author = {Brodaty, H. and McGilchrist, C. and Harris, L. and Peters, K. E.},
title = {{Time until institutionalization and death in patients with dementia. Role of caregiver training and risk factors}},
journal = {Archives of neurology},
year = {1993},
doi = {10.1001/archneur.1993.00540060073021},
pmid = {8503802},
url = {https://doi.org/10.1001/archneur.1993.00540060073021}
}
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