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The Impact of Educational Attainment and Income on Long-Term Care for Persons with Alzheimer's Disease and Other Dementias: A Swedish Nationwide Study
Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).ORCID iD: 0000-0002-8617-0355
Department of Social Work, Stockholm University, Stockholm, Sweden.
Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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2023 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, no 2, p. 789-800Article in journal (Refereed) Published
Sustainable development
00. Sustainable Development, 1. No poverty, 3. Good health and well-being, 10. Reduced inequalities
Abstract [en]

Background: Long-term care improves independence and quality of life of persons with dementia (PWD). The influence of socioeconomic status on access to long-term care was understudied.

Objective: To explore the socioeconomic disparity in long-term care for PWD.

Methods: This registry-based study included 14,786 PWD, registered in the Swedish registry for cognitive and dementia disorders (2014-2016). Education and income, two traditional socioeconomic indicators, were the main exposure. Outcomes were any kind of long-term care, specific types of long-term care (home care, institutional care), and the monthly average hours of home care. The association between outcomes and socioeconomic status was examined with zero-inflated negative binomial regression and binary logistic regression.

Results: PWD with compulsory education had lower likelihood of receiving any kind of long-term care (OR 0.80, 95% CI 0.68-0.93), or home care (OR 0.83, 95% CI 0.70-0.97), compared to individuals with university degrees. Their monthly average hours of home care were 0.70 times (95% CI 0.59-0.82) lower than those of persons with university degrees. There was no significant association between education and the receipt of institutional care. Stratifying on persons with Alzheimer's disease showed significant association between lower education and any kind of long-term care, and between income and the hours of home care.

Conclusions: Socioeconomic inequalities in long-term care existed in this study population. Lower-educated PWD were less likely to acquire general long-term care, home care and had lower hours of home care, compared to their higher-educated counterparts. Income was not significantly associated with the receipt of long-term care.

Place, publisher, year, edition, pages
IOS Press, 2023. Vol. 96, no 2, p. 789-800
Keywords [en]
aged care, Alzheimer's disease, dementia, disparity, education, home care, income, inequality, institutional care, long-term care, Alzheimer Disease, Educational Status, Humans, Quality of Life, Sweden, human, long term care
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:hj:diva-62952DOI: 10.3233/JAD-230388ISI: 001099536400029PubMedID: 37840486Scopus ID: 2-s2.0-85176971293Local ID: HOA;intsam;918083OAI: oai:DiVA.org:hj-62952DiVA, id: diva2:1815534
Funder
Swedish Research Council, 2022-01425Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01646Available from: 2023-11-29 Created: 2023-11-29 Last updated: 2024-01-09Bibliographically approved

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