Geschlechtsspezifische Prädiktoren von Institutionalisierung im Alter – Ergebnisse der Leipziger Längsschnittstudie in der Altenbevölkerung (LEILA 75+)

 

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Zusammenfassung

Anliegen Den meisten Menschen ist es ein zentrales Bedürfnis, in der vertrauten Umgebung und Häuslichkeit alt zu werden. Psychische Störungen wie Demenzen und Depressionen zählen zu den häufigsten Gründen für Heimeinweisungen im Alter. Die vorliegende Arbeit hat das Ziel, Geschlechtsunterschiede in Prädiktoren von Institutionalisierung zu untersuchen. Methode Die Datengrundlage bildet die Leipziger Langzeitstudie in der Altenbevölkerung (LEILA 75+), eine bevölkerungsrepräsentative Längsschnittstudie (n = 1058, 75+). Ergebnisse Für Frauen konnten kognitive Beeinträchtigungen sowie ein subjektiv schlechter Gesundheitszustand als starke Prädiktoren von Institutionalisierung nachgewiesen werden, während bei Männern Krankenhausaufenthalte innerhalb des zurückliegenden Jahres mit vorzeitigen Heimübergängen assoziiert waren. Für Männer gibt es außerdem Hinweise auf erhöhte Risiken im Zusammenhang mit dem Erleben von Verlusten in den Bereichen des sozioökonomischen Status und der Partnerschaft durch Verwitwung. Schlussfolgerungen Geschlechtsspezifischer Unterschiede haben eine hohe Relevanz bei der Entwicklung von Interventionen zur Vermeidung bzw. Verzögerung von Heimeintritten.

Abstract

Objective Especially given the different socialization and life conditions of men and women, it could not be assumed that factors leading to nursing home admission (NHA) can be equally applied to both genders. We aimed to determine gender-specific predictors of NHA. Methods Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,058 older adults were interviewed six times on average every 1.4 years. Sociodemographic, clinical, and psychometric variables were obtained. Cox proportional hazards regression was used to determine predictors of NHA. Results 10.3 % of men and 19.5 % of women (p < 0.001) were admitted to nursing home during the study period. The mean time to nursing home was 7.2 years for men and 6.8 years for women. Characteristics associated with a shorter time to NHA were increased age for men and women; cognitive impairment, poor self-rated health status, and less than two specialist's visits in the preceding 12 months for women, and being unmarried, moderate educational status, and hospitalization in the preceding 12 months were predictors of NHA for men. Conclusions Gender differences in prediction of NHA do actually exist. The inclusion of gender-specific factors in design and application of interventions to support individuals at home and delay or prevent NHA appears to be warranted.

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Dr. Melanie Luppa, Dipl.-Psych.

Universität Leipzig, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Public Health Research Unit

Semmelweisstraße 10

04103 Leipzig

Email: Melanie.Luppa@medizin.uni-leipzig.de