Hospitalization in community-dwelling persons with Alzheimer's disease: Frequency and causes

James L. Rudolph, Nicole M. Zanin, Richard N. Jones, Edward R. Marcantonio, Tamara G. Fong, Frances M. Yang, Liang Yap, Sharon K. Inouye

Research output: Contribution to journalArticle

116 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1542-1548
Number of pages7
JournalJournal of the American Geriatrics Society
Volume58
Issue number8
DOIs
StatePublished - Aug 1 2010

Keywords

  • Alzheimer's disease
  • delirium
  • dementia
  • geriatrics
  • hospitalization

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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    Rudolph, J. L., Zanin, N. M., Jones, R. N., Marcantonio, E. R., Fong, T. G., Yang, F. M., Yap, L., & Inouye, S. K. (2010). Hospitalization in community-dwelling persons with Alzheimer's disease: Frequency and causes. Journal of the American Geriatrics Society, 58(8), 1542-1548. https://doi.org/10.1111/j.1532-5415.2010.02924.x