AbstractThe Guy's/Age Concern Home Support Project is a prospective controlled intervention study of the effect of client‐centred home support for elderly people with dementia. Control subjects who were in institutions at six months follow‐up were significantly more depressed and physically disabled at referral than those who remained at home. Among those receiving additional home support, however, there was no difference between the depression and disability scores at referral of those who were institutionalized and those who remained at home at follow‐up. These results suggest that the high prevalence of depression and physical disability in the institutionalized elderly is due to preferential selection into institutions, and that this process is prevented by providing this form of domiciliary su