Hein P J van Hout

Amsterdam University Medical Center | VUmc · Department of General Practice and Elderly Care Medicine

Objectives: The objective of this article was to compare the costs and cost-effectiveness of the two most prominent types of case management in the Netherlands (intensive case management and linkage models) against no access to case management (control group) for people with already diagnosed dementia and their informal caregivers. Methods: The...

Background: Many older people worry about cognitive decline. Early cognitive screening in an anonymous and easily accessible manner may reassure older people who are unnecessarily worried about normal cognitive aging while it may also expedite help seeking in case of suspicious cognitive decline. Objective: To develop and validate online and teleph...

Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven ri...

Background: many instruments are available to identify frail older adults who may benefit from geriatric interventions. Most of those instruments are time-consuming and difficult to use in primary care. Objective: to select a valid instrument to identify frail older adults in primary care, five simple instruments were compared. Methods: instru...

Sophisticated approaches are needed to improve the quality of care for elderly people living in residential care facilities. We determined the effects of multidisciplinary integrated care on the quality of care and quality of life for elderly people in residential care facilities. We performed a cluster randomized controlled trial involving 10 resi...

Background: Routinely collected clinical data based on electronic medical records could be used to define frailty. Aim: To estimate the ability of four potential frailty measures that use electronic medical record data to identify older patients who were frail according to their general practitioner (GP). Design and setting: This retrospective coho...

Background The identification of dyadic subgroups of individuals living with dementia and their informal caregivers can help to design effective tailored support. In a previous German study, we identified six dementia dyad subgroups by applying Latent Class Analysis (LCA). Results showed sociodemographic heterogeneity as well as differences in heal...

Aims This study explored what informal caregivers of ethnic minority (EM) persons with dementia in the Netherlands perceive as culturally accessible health care and nurses' perceptions of how cultural competence can be improved to facilitate access to health care for EM persons with dementia and their informal caregivers. Design Qualitative descri...

Certain diseases and malnutrition are known to co-occur in residents of long-term care facilities (LTCF). We assessed which diseases and health-related problems are associated with malnutrition at admission or with incident malnutrition during stays and how different definitions of malnutrition affect these associations. Data of Dutch LTCF resident...

The concept of resilience, i.e., the capacity of a system to bounce back after a stressor, is gaining interest across many fields of science, policy and practice. To date, resilience research in people with cognitive decline has predominantly addressed the early stages of decline. We propose that: (1) resilience is a relevant concept in all stages...

Objectives The researchers aimed to (1) explore the occurrence of psychological resilience in the face of a major life stressor and conflict in older residents of long-term care facilities (LTCFs), and (2) identify factors associated with resilience in this population. Design Longitudinal cohort study using the Dutch InterRAI-LTCF cohort. Setting...

Background Identification of community-dwelling older adults at risk of unplanned hospitalizations is of importance to facilitate preventive interventions. Our objective was to review and appraise the methodological quality and predictive performance of prediction models for predicting unplanned hospitalizations in community-dwelling older adults...

Objectives We aimed to explore the effects of the Dutch COVID-19 lockdown (March 20-May 25, 2020) on mood, behavior and social and cognitive functioning of older residents of long-term care facilities (LTCFs) prospectively. Design Mixed methods:1.Historically controlled longitudinal cohort study, 2.Focus groups Setting and participants Residents...

Objectives To investigate the cross-sectional and prospective associations between behavior and cognitive problems and malnutrition in long-term care facilities (LTCF). Design Cross-sectional and prospective routine care cohort study. Setting 6874 Residents in Dutch LTCFs (period 2005–2020). Participants Data were obtained from the InterRAI-LTCF...

Background and importance Falls among older people occur frequently and are a leading cause of Emergency department (ED) admissions, disability, death and rising health care costs. Multifactorial fall prevention programs that are aimed to target the population at risk have shown to effectively reduce the rate of falling and fall-related injuries in...

Background Mood disturbance is a pervasive problem affecting persons of all ages in the general population and the subset of those receiving services from different health care providers. interRAI assessment instruments comprise an integrated health information system providing a common approach to comprehensive assessment of the strengths, prefere...

Introduction Resilience incorporates the presence of a positive response to some type of stressor. To properly explore resilience, it is important to systematically identify relevant stressors. We aimed to identify (combinations of) stressors with the strongest relationship with observer-reported and self-reported mood outcomes in older residents o...

Objective To compare facility-level influenza vaccination rates in long-term care (LTC) homes from four countries and to identify factors associated with influenza vaccination among residents. Design and setting Retrospective cross-sectional study of individuals residing in LTC homes in New Brunswick (Canada), New Zealand, Switzerland, and the Net...

Background Advance care planning (ACP) is a process of communication in which patients and family caregivers discuss preferences for future care with the healthcare team. For persons with dementia, it is crucial to timely engage in ACP. Therefore, we study ACP in dementia using electronic health record data. This study aims to determine how often A...

1. In a sample of memory clinic attendees ranging from memory complaints to dementia. 2. A large community dwelling sample.

Objectives The aim was to characterize multimorbidity patterns in a large sample of older individuals living in nursing homes (NHs) and to investigate their association with mortality, also considering the effect of functional status. Design Observational and retrospective study. Setting and Participants We analyzed data on 4131 NH residents in I...

Introduction: Impaired awareness in dementia caused by Alzheimer’s disease and related disorders made study partner-report the preferred method of measuring interference in “instrumental activities of daily living” (IADL). However, with a shifting focus toward earlier disease stages and prevention, the question arises whether self-report might be e...

The number of persons with dementia from ethnic minority backgrounds is increasing. However, ethnic minority groups use health care services less frequently compared to the general population. We conducted a scoping review and used the theoretical framework developed by Levesque to provide an overview of the literature concerning access to health c...

Objective To develop an algorithm (sCOVID) to predict the risk of severe complications of COVID-19 in a community-dwelling population to optimise vaccination scenarios. Design Population-based cohort study. Setting 264 Dutch general practices contributing to the NL-COVID database. Participants 6074 people aged 0–99 diagnosed with COVID-19. Main...

Increased public awareness of cognitive decline among older adults increases the need for reliable self‐testing of cognitive performance at home. In this study, we aimed to assess the usability of unsupervised, at‐home cognitive testing using the Cognitive Online Self‐Test Amsterdam (COST‐A). We established norm scores in a reference sample and val...

With the shift towards preclinical phases of Alzheimer’s disease (AD) and other neurodegenerative diseases in research studies and clinical trials, the question arises if participants can reliably self‐report their level of everyday functioning. Here, we aim to investigate the factors related to concordance between participant‐ and study partner‐re...

Background: the number of persons with dementia from ethnic minority backgrounds is increasing. However, ethnic minority groups use health care services less frequently compared to non-migrants. Method: We conducted a scoping review and used the theoretical framework developed by Levesque to provide an overview of the literature concerning acces...

INTRODUCTION: Impaired awareness in dementia due to Alzheimers disease and related disorders, made study partner-report the preferred method of measuring interference in instrumental activities of daily living (IADL). However, with a shifting focus towards earlier disease stages and prevention, the question arises whether self report might be equal...

Background: Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. Methods: Three thousand eighty-eight...

Background: To be able to provide high-quality palliative care, there need to be a number of organizational structures available in the nursing homes. It is unclear to what extent such structures are actually present in nursing homes in Europe. We aim to examine structural indicators for quality of palliative care in nursing homes in Europe and to...

Studies which examined the association between sedentary behavior (SB) and cognitive function have presented equivocal findings. Mentally active/inactive sedentary domains may relate differently to cognitive function. We examined associations between SB and cognitive function, specifically focusing on different domains. Participants were recruited...

Introduction: This study aims to provide insight into the prevalence of health problems and the frequency of general practitioner (GP) contacts in cohabiting partners of persons with dementia, during the year prior to the dementia diagnosis and up to 3 years after the diagnosis. Methods: Partners of persons with dementia and a matched control gr...

The Camberwell Assessment of Need for the Elderly (CANE) is an internationally accepted tool for assessing the needs of older people. Needs are assessed in twenty-four areas of life and cover a broad range of health, social and psychological domains. Two items that measure the needs of those who care for the older person are also included. The CANE...

This study aims to benchmark mean societal costs per client in different home care models and to describe characteristics of home care models with the lowest societal costs. In this prospective longitudinal study in 6 European countries, 6-month societal costs of resource utilization of 2060 older home care clients were estimated. Three care models...

APPROACH We collated longitudinal data from 52 million older recipients of home care and nursing home care from eight countries including (1) highly reliable, valid and harmonised comprehensive assessments of functional capacities, diseases, and treatments, linked with (2) administrative repositories on mortality and care use. We develop and valida...

Background: Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven r...

Residents of long-term care (LTC) homes have suffered disproportionately during the Covid-19 pandemic, from the virus itself and often from the imposition of lockdown measures. Provincial Geriatrics Leadership Ontario, in collaboration with interRAI and the International Federation on Aging, hosted a virtual Town Hall on September 25 2020. The purp...

Objectives: Research on life stressors and adverse life events has a long tradition. Few studies have addressed this topic in connection to very old people. Life stressors, especially major life stressors (MLSs) experienced by clients of home care services in the community have rarely been the subject of studies. Considering this gap, we investigat...

Objective: To develop an algorithm (sCOVID) to predict the risk of severe complications of COVID-19 in a community-dwelling population to optimise vaccination scenarios. Design: Population based cohort study Setting: 264 Dutch general practices contributing to the NL-COVID database Participants: 6074 people aged 0-99 diagnosed with COVID-19 Main ou...

Introduction: Frailty can be seen as a continuum, from fit to frail. While many recent studies have focused on frailty, much less attention has been paid to the other end of the continuum: the group of older adults that remain (relatively) vital. Moreover, there is a lack of studies on frailty and vitality that investigate predictors from multiple...

Objective To prevent osteoporotic fractures in nursing home residents a combination of bisphosphonates, calcium and vitamin D is recommended. This study assessed the prevalence of pharmacological osteoporosis prevention in nursing home residents from eight countries, and assessed its association with patient characteristics. Design Cross-sectional...

This study aims to develop and validate a prediction model of societal costs during a period of 6-months in older community care-recipients across multiple European countries. Participants were older community care-recipients from 5 European countries. The outcome measure was mean 6-months total societal costs of resource utilisation (healthcare an...

Introduction: In the Netherlands, as in many other countries, current clinical guidelines are directed at single diseases. Patients with multiple chronic conditions may benefit from a more patient-tailored approach. Therefore, our objective is to explore the general practice care needs of patients with multimorbidity from a patient perspective. We...

Study partner report is used to assess cognitively complex everyday activities, or instrumental activities of daily living (IADL). Because a study partner is not always available, the question arises whether IADL can also be evaluated using self‐report. The aim of this study is to investigate the relationship between study partner‐ and self‐report...

Objectives To evaluate whether the prevalence of health problems in cohabiting partners of people with dementia differs between the year before and the year after three transitions: the diagnosis of dementia, institutionalization and the death of the person with dementia. Methods Individuals with dementia and their partners were identified on the...

Frail older people face a range of problems and risks that could undermine their ability to live safely at home. A comprehensive overview of these risks, from a multidimensional perspective, is currently lacking. This study aims to examine the prevalence of risks in multiple domains of life among frail older people living at home. We used cross‐sec...

Background: Psychotropic drugs are frequently prescribed to people with dementia in nursing homes although severe adverse events and side effects are common. Less is known about the prevalence and types of psychotropic drug prescription in primary care for people with dementia. Objective: This study examined the prevalence of psychotropic drug pres...

Supplement of the Review Resilience in Aging

Objectives Anticholinergic/antimuscarinic and sedative medications (eg, benzodiazepines) have been found to be associated with poorer cognitive and physical function and mobility impairment in older age. However, previous studies were mostly conducted among community-dwelling older individuals and had often a cross-sectional design. Accordingly, ou...

Although ageing research increasingly incorporates resilience, a common notion on what resilience means is lacking. We aimed to give a comprehensive overview of the conceptual literature on resilience in older persons, identifying areas of consensus and variation/debate. A systematic search of eight databases from different disciplines led to the i...

Frailty management focuses on optimizing the physical and psychological functioning of older people with frail health through early risk identification and intervention in primary care. Such care programs demand a joint effort by primary care professionals and older persons, one in which professionals are expected to promote or facilitate self-mana...

In many countries, residential care for older people was not prepared for a public health crisis: although it was very clear that frail older people were most vulnerable to COVID-19, these places, with the highest concentration of this population, did not have the necessary resources, had no plan, and became the focus of attention too late. As a co...

Introduction: Reliable estimates of time from diagnosis until institutionalization and death in people with dementia from routine nationally representative databases are lacking. Methods: We selected 9230 people with dementia and 24,624 matched controls from family physicians' electronic records linked with national administrative databases to a...

Background The number of older people dying in long-term care facilities is increasing; however, care at the end of life can be suboptimal. Interventions to improve palliative care delivery within these settings have been shown to be effective in improving care, but little is known about their implementation. Aim The aim of this study was to descr...

Objectives To estimate (1) the duration of no formal care, home care, and institutional care after dementia diagnosis, and (2) the effect of age, sex, living situation, dementia medication, migration background, and income on this dementia care duration. Design Longitudinal retrospective study using routinely recorded general practice electronic h...

Objectives The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions i...

Background: The PACE 'Steps to Success' programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, this programme has been implemented in 37 LTCFs in 7 European countries. Alongside an effectiveness study, a process evaluation...

Importance High-quality evidence on how to improve palliative care in nursing homes is lacking. Objective To investigate the effect of the Palliative Care for Older People (PACE) Steps to Success Program on resident and staff outcomes. Design, Setting, and Participants A cluster-randomized clinical trial (2015-2017) in 78 nursing homes in 7 count...

Across Europe, an increasing number of older people with multiple health and social care needs stay in their own homes until old age. Community care aims to support them to live at home for as long as possible. Comparative studies showed that population characteristics of older community care recipients differ between European countries. This is du...

Objectives To develop and validate a prediction model of societal costs during a period of six-month in older community care-recipients across multiple European countries. Methods Data from the IBenC study were used. Participants were older community care-recipients from five European countries. The outcome measure was mean six-months total societ...

Objectives: The prevalence of different geriatric syndromes in older home care (HC) recipients is yet to be determined. Dizziness is often regarded as a geriatric syndrome. The natural course of dizziness in older people is still unknown, because of a lack of longitudinal studies. The objective of this study was to investigate the prevalence and p...

Aim To develop a proactive person-centered care approach for persons with (multiple) chronic diseases in general practice, and to explore the impact on ‘Quadruple aims’: experiences of patients and professionals, patient outcomes and costs of resources use. Background The management of people with multiple chronic diseases challenges health care s...

Objective: To examine factors associated with perceived quality of communication with physicians by relatives of dying residents of long-term care facilities (LTCFs). Design: A cross-sectional retrospective study in a representative sample of LTCFs conducted in 2015. In each LTCF, deaths of residents during the 3 months before the researcher's v...

Background: In long-term care facilities often many care providers are involved, which could make it difficult to reach consensus in care. This may harm the relation between care providers and can complicate care. This study aimed to describe and compare in six European countries the degree of consensus among everyone involved in care decisions, f...