Community Services, Progression Rate, and Nursing Home Placement In Persons with Alzheimer’s Disease

There are many factors influencing when a person with Alzheimer’s disease (AD) or another dementia is placed in a nursing home (NHP). The aims of this study were to determine if introducing home and community-based services (HCBS) at different stages of disease severity influenced time to NHP in a sample of persons living with AD (n = 1210); examine if disease pre-progression rate (PPR) influenced time to NHP; and explore the interaction between disease severity at first use of HCBS and PPR on time to NHP. Findings suggested that earlier introduction of HCBS delayed time to NHP in a univariate model (p = 0.03), but not when covariates were adjusted (p = 0.39); faster PPR resulted in earlier NHP in both univariate (p < 0.001) and covariate adjusted models (p < 0.01); and earlier introduction of HCBS delayed time to NHP (even when PPR was taken into consideration). Implications are discussed