Predictors of Residential Care Admission in Community-Dwelling Older People With Dementia.

The study is observational, so it cannot show that any factor caused residential care admission. It included only community-dwelling older people who had an interRAI-HC assessment and consented, so it may not apply to older people with simpler needs or those who did not consent. Residential care entry was captured from a database covering about 90% of subsidised ARC admissions; self-funded admissions may be missing. The strongest predictor, the better off living elsewhere response, did not record whether the person or relative answered it, nor was it an assessment of the living environment. Recent hospitalisation was reported as associated with reduced residential care entry in the results, but listed as a main risk factor in the conclusion. 52 of 18,672 participants had missing data, and the authors did not impute missing values. Alcohol categories were collapsed because of small numbers, and lifetime abstainers could not be distinguished from recent non-drinkers.

The authors declared no conflicts of interest. The supplied metadata lists NIH extramural research support, but the article text does not state a funding source.

Do not read these associations as evidence that ADL support, treating depression, or reducing isolation will delay residential care. The study cannot infer causality, and the most ADL-dependent group had lower residential care entry partly because they were more likely to die first.