OBJECTIVES: This study aims to identify and compare sociodemographic and health-related factors that predicted transitions into nursing homes in Sweden between 2020 and 2022, further examining the role of dementia as a modifier in these associations. DESIGN: Register-based nested case-control study. SETTING AND PARTICIPANTS: We identified all incident transitions to nursing homes among residents of Sweden, aged 65+ years, between 2020 and 2022 (n = 84,621). Twenty controls per case were randomly selected, matched on birth year, sex, and county. National register data were linked to all participants. METHODS: Descriptive analyses and multivariate logistic regression were used to examine the associations between sociodemographic factors (age, sex, education, cohabitation, children, income, and urbanicity of municipality) and health-related (dementia, multimorbidity, home care, and inpatient care) factors and incident nursing home entry between 2020 and 2022. Stratified analyses and multiplicative interactions tests were conducted to assess the potential modifying role of dementia in these associations. RESULTS: Home care receipt low intensity: odds ratio (OR), 2.36; 95% CI, 2.31-2.41; high intensity: OR, 6.00; 95% CI, 5.89-6.12) and dementia (OR, 4.70; 95% CI, 4.62-4.78 emerged as the strongest predictors of nursing home entry. Notably, the descriptive analyses revealed a dose-response relationship between age and nursing home entry. The association between many factors (eg, home care, inpatient care) and nursing home entry was weaker among those with dementia, whereas living alone was associated with decreased odds of nursing home entry in those with dementia. CONCLUSIONS AND IMPLICATIONS: Home care and dementia were the primary drivers of nursing home entry in Sweden between 2020 and 2022, while social factors played a smaller role. Further investigations should ensure that those with dementia who are living alone or have multimorbidity are receiving adequate care. With continued population aging, it is essential that we monitor and adapt our policies and systems to ensure needs dictate access to care.
Högström et al. (2026) studied this question.