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Background: A living will document is known to be an important tool for preparing for future care together with healthcare professionals. A living will supports an older person's self-determination and autonomy. Only a few studies have approached the underlying factors of a living will document among older long-term care recipients. Objectives: To explore how common having a living will was among older persons receiving home care or round-the-clock long-term care, as well as to evaluate associations between socio-demographical factors and functional capacity with a living will. Design: The study population consisted of older persons receiving long-term care in Finland in 2016–2017. Data were collected via individual assessments at home or at a care facility. The questions in the assessment covered health, functional capacity, service use, and social support. Methods: Primary outcome 'living will' and associated factors were identified for each person aged 65 or older from RAI-assessment data (Resident Assessment Instrument, RAI). Cross-tabulations with χ²-tests and adjusted binary logistic regression models were performed to evaluate the association between the factors and a living will. Results: Of the 10,178 participants, 21% had a living will – a greater proportion were female (22%) than male (18%), and a greater proportion of residents in assisted living (25%) and residential care homes (20%) compared with home care residents (15%) had a living will. Female gender (p < 0.001), having a proxy decision-maker (p = 0.001), increasing age (p = 0.003), impairing functional capacity (activities of daily living hierarchy p < 0.001, Cognitive Performance Scale p < 0.001), instability of health status (Changes in Health, End-Stage Disease and Signs and Symptoms p < 0.001), and closeness of death (p < 0.001) were significantly associated with a living will among older persons. Extensive differences in results were found between home care clients and clients of round-the-clock long-term care. Conclusion: Preparedness for the future with a living will varies according to services and on individual level. To reduce inequalities in end-of-life care, actions for advance care planning with appropriate timing are warranted. [ABSTRACT FROM AUTHOR]

Background: The prevalence of depression has been evaluated in populations of low- and middle-income (LMI) countries but the risk of depression has not been specified among persons with dementia. This cross-sectional analysis aimed to assess the prevalence and risk of depression among older people with dementia living in LMI countries. Methods: The study analysed data from a population-based survey conducted by 10/66 Dementia Research Group in 2004. Altogether, 17 031 participants from eight different countries aged 65 years and above were assessed. Logistic regression was used to calculate prevalence and odds ratio (OR) of depression on persons with dementia. Adjustments by age and education were included in the analysis. ORs of depression on different types of dementia were determined. Results: Depression was identified in 5.8% (4.4% of men, 6.6% of women) of all the 17 031 participants and in 12.4% (18.9% of men, 10.1% of women) of the 1612 persons with dementia. Persons with dementia had an increased risk of depression compared with persons without dementia, the age- and education-adjusted OR was 2.38 [95% confidence interval (CI0 1.99–2.84]); 3.86 (95% CI 2.83–5.26) for men and 1.88 (95% CI 1.51–2.35) for women. Compared with Alzheimer’s disease, Lewy body [OR 2.75 (95% CI 1.40–3.72)] and vascular dementia [OR 2.35, (95% CI 1.49–3.72)] were associated with a higher risk of depression. Conclusions: Persons with dementia were twice as likely to have depression as persons without dementia. Among persons with dementia, the prevalence of depression was higher for men than women, and the risk of depression varied by the type of dementia. [ABSTRACT FROM PUBLISHER]