Dementia in the acute hospital: the prevalence and clinical outcomes of acutely unwell patients with dementia

Briggs, Robert; Dyer, Adam H.; Nabeel, Shamis; Collins, Rónán; Doherty, John U.; Coughlan, Tara; O’Neill, Desmond; Kennelly, Sean

doi:10.1093/qjmed/hcw114

Cited by 88 publications

(89 citation statements)

References 24 publications

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“…8,16,18,19,22,23,25,[29][30][31][32] Three were intervention studies, that is, one randomized controlled trial (RCT) 26 and two quasiexperimental studies. 9,20,21,23,[27][28][29]32 Various data sources were used, including patient medical records (n = 12, 67%), 9,16,17,[19][20][21]23,[26][27][28][29]31,32 billing and/or claims files (n = 6, 33%), 8,16,18,20,22,25 registry data (n = 5, 28%), 9,16,24,30,31 and surveys and/or interviews (n = 9, 50%). 9,20,21,23,[27][28]…”

Section: Quality Appraisal Of Reviewed Studiesmentioning

confidence: 99%

“…4 Hospital readmissions are a serious patient safety issue that is under increasing regulatory scrutiny. 9 Several key factors may contribute to the high rates of hospital readmission in persons with dementia, especially those readmissions that may be unnecessary and preventable. 6,7 Persons with dementia are likely to be at high risk for hospital readmissions.…”

Section: Introductionmentioning

confidence: 99%

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Hospital readmission in persons with dementia: A systematic review

Bao

Dull

et al. 2019

Int J Geriat Psychiatry

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Objective Hospital readmission in persons with dementia is becoming a critical safety and cost issue. The purpose of this review is to systematically assess published evidence on hospital readmissions in persons with dementia, including rate, clinical reasons, risk factors, and prevention programs. Methods A systematic review of relevant literature was conducted. Literature were searched in PubMed, CINAHL, PsycINFO, and Embase as well as hand searching. Quality of reviewed studies were assessed independently by reviewers using quality assessment checklists. Results Nineteen studies met the inclusion criteria and were reviewed. In persons with dementia, all‐cause 30‐day readmission rate was most frequently reported and ranged from 7% to 35%. Compared with those without dementia, persons with dementia had significantly higher rate of readmission. Reported risk factors of readmission varied across studies from patient sociodemographic and clinical status, history of health care utilization, to family caregivers. Reasons for readmission were rarely documented. Programs of home‐based individualized care and interdisciplinary team care were used for preventing readmissions. Findings from some of the studies were limited by small sample sizes, single data source, and other methodologic flaws. Conclusions Persons with dementia are at high risk for hospital readmission, but many of the readmissions are potentially preventable. Multiple strategies such like identifying high‐risk individuals and the clinical reasons for index admission and readmission and implementing home‐based individualized care by interdisciplinary team can reduce preventable hospital readmissions. Future studies should use multiple national data sources and advanced methodology to identify risk factors and clinical reasons of hospital readmissions.

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Section: Quality Appraisal Of Reviewed Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hospital readmission in persons with dementia: A systematic review

Bao

Dull

et al. 2019

Int J Geriat Psychiatry

View full text Add to dashboard Cite

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“…Patients in hospital with dementia are 4 to 7 years older, more likely to be women, and more likely to live in a care home than those without dementia [5]. Three-quarters of hospitalised patients with dementia have been defined as frail, compared to one-quarter of similar people without dementia [7]. …”

Section: What Is the Problem?mentioning

confidence: 99%

Challenges and opportunities in understanding dementia and delirium in the acute hospital

et al. 2017

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“…The evidence shows that cognitive impairments must be actively identified for appropriate management to be undertaken [25–28]. Studies [26, 28, 29] have shown that cognitive impairment is under-detected, and that lack of detection is linked to poorer care. There is a lack of awareness among hospital staff of the importance of identification coupled with inadequate knowledge and skills to detect cognitive impairment [26, 28, 29].…”

Section: Recognition Of the Needmentioning

confidence: 99%

“…Studies [26, 28, 29] have shown that cognitive impairment is under-detected, and that lack of detection is linked to poorer care. There is a lack of awareness among hospital staff of the importance of identification coupled with inadequate knowledge and skills to detect cognitive impairment [26, 28, 29]. Dementia alone is rarely the reason for their admission although this may well be the underlying cause.…”

Section: Recognition Of the Needmentioning

confidence: 99%

Optimising care for patients with cognitive impairment and dementia following hip fracture

et al. 2017

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The global shift in demographics towards aging populations is leading to a commensurate increase in age-related disease and frailty. It is essential to optimise health services to meet current needs and prepare for anticipated future demands. This paper explores issues impacting on people living with cognitive impairment and/or dementia who experience a hip fracture and are cared for in acute settings. This is important given the high mortality and morbidity associated with this population. Given the current insufficiency of clear evidence on optimum rehabilitation of this patient group, this paper explored three key themes namely: recognition of cognitive impairment, response by way of training and education of staff to optimise care for this patient group and review of the importance of outcomes measures. Whilst there is currently insufficient evidence to draw conclusions about the optimal ways of caring for patients living with dementia following hip fracture, this paper concludes that future research should improve understanding of healthcare staff education to improve the outcomes for this important group of patients.

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Dementia in the acute hospital: the prevalence and clinical outcomes of acutely unwell patients with dementia

Abstract: A diagnosis of dementia confers an increased risk of either death or further admission within the following 12 months, highlighting the need for better cognitive screening in the acute setting, as well as targeted intervention such as comprehensive geriatric assessment.

Cited by 88 publications

References 24 publications

Hospital readmission in persons with dementia: A systematic review

Hospital readmission in persons with dementia: A systematic review

Challenges and opportunities in understanding dementia and delirium in the acute hospital

Optimising care for patients with cognitive impairment and dementia following hip fracture

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