Hospitalizations in older‐adults newly diagnosed with dementia: A population‐based longitudinal study in Israel. (22nd January 2023)

• Record Type: Journal Article
• Authors: Lutski, Miri; Shahar, Rotem; Vered, Shiraz; Novick, Deborah; Zucker, Inbar; Weinstein, Galit
• Is Part Of: International journal of geriatric psychiatry. Volume 38:Number 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-01-22
• Subjects: dementia -- hospital admissions -- hospitalization -- length of stay -- registry data -- risk factors; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5871
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Objectives: To compare inpatient burden (i.e. likelihood of hospitalization, number of admissions and length of stay) in persons with newly diagnosed dementia to the general population without dementia. Additionally, to evaluate whether inpatient burden is increased during the years prior to and post dementia diagnosis, and to identify factors associated with increased inpatient burden. Method: The Israeli National Dementia Dataset (2016) was cross‐linked with the National Hospital Discharge Database of the Israeli Ministry of Health (2014–2018). Dementia definition was based on documented dementia diagnoses and/or the purchase of medications during 2016. Mixed‐effects models were applied to identify demographic and health characteristics associated with inpatient burden in the one and 2 years prior to and after dementia diagnosis. Results: The dataset included 11, 625 individuals aged ≥65 years, identified as incident dementia cases. Compared to the general population of older‐adults without dementia, those with newly diagnosed dementia had a higher age‐standardized proportion of hospitalizations (26.4% vs. 40%). The odds for hospitalization were highest during the year preceding dementia diagnosis (OR = 3.19, 95% CI 2.51–4.06) compared to 2 years prior to diagnosis, and remained high (although slightly decreased) after dementia diagnosis. Older age was associated with inpatient burden after, but not prior to dementia diagnosis. Conclusions: Older persons with dementia are a vulnerable population group with increased utilization of inpatient burden compared to those without dementia, particularly in the years surrounding dementia diagnosis. Sociodemographic risk factors may differ with respect to the time surrounding dementia diagnosis. Key points: Older persons with dementia are a vulnerable population group with increased inpatient burden compared to those without dementia. The odds for hospitalization were highest during the year preceding dementia diagnosis (compared to 2 years prior to diagnosis, and remained high after dementia diagnosis. Some associations of age, sex, comorbidity burden and BMI with hospitalization of individuals with newly diagnosed dementia were modified by time respective to the dementia diagnosis. Older age was associated with inpatient burden after, but not prior to dementia diagnosis.