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 Margaret Yang, Liang Yap, Sharon K. Inouye

Research output: Contribution to journalArticle

98 Citations (Scopus)

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

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Independent Living
Alzheimer Disease
Hospitalization
Confidence Intervals
Dementia
Medicare
Comorbidity
Delirium
Gastrointestinal Diseases
Sex Ratio
Syncope
Research
Myocardial Ischemia
Registries
Pneumonia
Demography
Databases
Interviews

Keywords

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

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Rudolph, J. L., Zanin, N. M., Jones, R. N., Marcantonio, E. R., Fong, T. G., Yang, F. M., ... 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

Hospitalization in community-dwelling persons with Alzheimer's disease : Frequency and causes. / Rudolph, James L.; Zanin, Nicole M.; Jones, Richard N.; Marcantonio, Edward R.; Fong, Tamara G.; Yang, Frances Margaret; Yap, Liang; Inouye, Sharon K.

In: Journal of the American Geriatrics Society, Vol. 58, No. 8, 01.08.2010, p. 1542-1548.

Research output: Contribution to journalArticle

Rudolph, JL, Zanin, NM, Jones, RN, Marcantonio, ER, Fong, TG, Yang, FM, Yap, L & Inouye, SK 2010, 'Hospitalization in community-dwelling persons with Alzheimer's disease: Frequency and causes', Journal of the American Geriatrics Society, vol. 58, no. 8, pp. 1542-1548. https://doi.org/10.1111/j.1532-5415.2010.02924.x
Rudolph, James L. ; Zanin, Nicole M. ; Jones, Richard N. ; Marcantonio, Edward R. ; Fong, Tamara G. ; Yang, Frances Margaret ; Yap, Liang ; Inouye, Sharon K. / Hospitalization in community-dwelling persons with Alzheimer's disease : Frequency and causes. In: Journal of the American Geriatrics Society. 2010 ; Vol. 58, No. 8. pp. 1542-1548.
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