1These authors contributed equally and have agreed to share first authorship.
Hospitalization in Community-Dwelling Persons with Alzheimer's Disease: Frequency and Causes
Article first published online: 9 JUN 2010
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 58, Issue 8, pages 1542–1548, August 2010
How to Cite
Rudolph, J. L., Zanin, N. M., Jones, R. N., Marcantonio, E. R., Fong, T. G., Yang, F. M., Yap, L. and Inouye, S. K. (2010), Hospitalization in Community-Dwelling Persons with Alzheimer's Disease: Frequency and Causes. Journal of the American Geriatrics Society, 58: 1542–1548. doi: 10.1111/j.1532-5415.2010.02924.x
- Issue published online: 3 AUG 2010
- Article first published online: 9 JUN 2010
- Alzheimer's disease;
OBJECTIVES: To examine the rates of and risk factors for acute hospitalization in a prospective cohort of older community-dwelling patients with Alzheimer's disease (AD).
DESIGN: Longitudinal patient registry.
SETTING: AD research center.
PARTICIPANTS: Eight hundred twenty-seven older persons with AD.
MEASUREMENTS: Acute hospitalization after AD research center visit was determined from a Medicare database. Risk factor variables included demographics, dementia-related, comorbidity and diagnoses and were measured in interviews and according to Medicare data.
RESULTS: Of the 827 eligible patients seen at the ADRC during 1991 to 2006 (median follow-up 3.0 years), 542 (66%) were hospitalized at least once, and 389 (47%) were hospitalized two or more times, with a median of 3 days spent in the hospital per person-year. Leading reasons for admission were syncope or falls (26%), ischemic heart disease (17%), gastrointestinal disease (9%), pneumonia (6%), and delirium (5%). Five significant independent risk factors for hospitalization were higher comorbidity (hazard ratio (HR)=1.87, 95% confidence interval (CI)=1.57–2.23), previous acute hospitalization (HR=1.65, 95% CI=1.37–1.99), older age (HR=1.51, 95% CI=1.26–1.81), male sex (HR=1.27, 95% CI=1.04–1.54), and shorter duration of dementia symptoms (HR=1.26, 95% CI=1.02–1.56). Cumulative risk of hospitalization increased with number of risk factors present at baseline: 38% with zero factors, 57% with one factor, 70% with two or three factors, and 85% with four or five factors (Ptrend<.001).
CONCLUSION: In a community-dwelling population with generally mild AD, hospitalization is frequent, occurring in two-thirds of participants over a median follow-up time of 3 years. With these results, clinicians may be able to identify dementia patients at high risk for hospitalization.