Hospitalization outcomes among older adults living undiagnosed or unaware of dementia.

IF 4 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2025-01-16 eCollection Date: 2025-01-01 DOI:10.1002/dad2.70051

Halima Amjad, Vishaldeep K Sekhon, Jennifer L Wolff, Quincy M Samus, David L Roth

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Abstract

Introduction: Many persons with dementia are undiagnosed or unaware of dementia, which may affect hospitalization outcomes.

Methods: We evaluated differences in length of stay, days not at home, discharge destination, and 30-day readmissions over 1 year in 6296 older adults in the National Health and Aging Trends Study with linked Medicare claims. Multivariable-adjusted models compared outcomes across no dementia, undiagnosed dementia, unaware but diagnosed with dementia, and aware and diagnosed with dementia.

Results: Persons with undiagnosed dementia had longer length of stay and were more likely to be discharged to a facility (44.8% vs. 19.3%) compared to no dementia; differences persisted in multivariable models. Persons undiagnosed or unaware experienced outcomes similar to persons aware and diagnosed except for more 30-day readmissions in the undiagnosed (adjusted odds ratio [95% confidence interval] 2.05 [1.01, 4.16]).

Discussion: Persons undiagnosed or unaware of dementia experience worse hospitalization outcomes, suggesting potential clinically significant implications of unrecognized dementia.

Highlights: Persons with undiagnosed versus no dementia have worse hospitalization outcomes.Persons with undiagnosed dementia have more 30-day readmissions compared to persons diagnosed.Lack of clinician or family recognition of dementia may adversely affect hospitalization outcomes.

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未确诊或未意识到痴呆的老年人的住院结果

许多痴呆症患者未被诊断或未意识到痴呆症，这可能影响住院结果。方法：我们在国家健康和老龄化趋势研究中评估了6296名老年人1年内住院时间、不在家天数、出院目的地和30天再入院的差异，并与医疗保险索赔相关。多变量调整模型比较了无痴呆、未确诊痴呆、未意识到但确诊痴呆和意识到并确诊痴呆的结果。结果：与无痴呆患者相比，未确诊痴呆患者的住院时间更长，出院的可能性更大（44.8%对19.3%）；在多变量模型中，差异依然存在。未确诊或不知情者的结果与确诊和知情者相似，但未确诊者30天再入院率更高（校正优势比[95%置信区间]2.05[1.01,4.16]）。讨论：未确诊或未意识到痴呆的患者住院治疗结果更差，提示未被识别的痴呆具有潜在的临床意义。重点：未确诊痴呆患者与未确诊痴呆患者相比，住院结果更差。与确诊的痴呆症患者相比，未确诊的痴呆症患者在30天内再入院的时间更长。缺乏临床医生或家庭对痴呆症的认识可能会对住院结果产生不利影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.