[O5–03–02]: TRENDS IN HEALTH SERVICE USE AND POTENTIALLY AVOIDABLE HOSPITALIZATIONS PRIOR TO ALZHEIMER's DISEASE DIAGNOSIS: A MATCHED, RETROSPECTIVE STUDY OF U.S. MEDICARE BENEFICIARIES

Desai, Urvi; Kirson, Noam Y.; Mehta, Nori R.; Wen, Jody; Sheng, Yanying; Ye, Wenyu; Andrews, Jeffrey Scott

doi:10.1016/j.jalz.2017.07.519

Cited by 5 publications

(10 citation statements)

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“…Our findings, that high BMI is associated with lower odds for hospitalizations, fewer admissions and shorter hospital stays in the year before and after dementia diagnosis is in agreement with evidence showing that lower weight in old age is associated with an increased risk of hospitalizations 36,37 . These findings may also reflect the fact that weight loss may occur as a result of the unstable health status associated with the diagnosis of dementia, 38 together with a simultaneous greater use of health care services including hospital admissions 24 . Additionally, we observed an unexpected association between comorbidity burden and decreased hospitalization burden in the time period immediately following dementia diagnosis.…”

Section: Discussionsupporting

confidence: 86%

“…However, most of these studies focused on overall health costs and not particularly on the burden caused by hospitalizations 12,13,21,23,24 . Similar to our findings, the likelihood of all‐cause hospitalizations increased during the period preceding AD diagnosis among Medicare users 24 . Furthermore, similar trends were observed in a Finnish sample, where persons with AD had higher mean total medical care costs, particularly hospital care costs, starting from 0.5–1 years before the diagnosis of AD and remaining high until 2 years after the diagnosis, when the follow‐up time ended 13 .…”

Section: Discussionsupporting

confidence: 85%

“…In addition, limited literature also suggests that even prior to dementia diagnosis, individuals may begin using more health care services and have higher expenditures associated with health 21 . However, most of these studies focused on overall health costs and not particularly on the burden caused by hospitalizations 12,13,21,23,24 . Similar to our findings, the likelihood of all‐cause hospitalizations increased during the period preceding AD diagnosis among Medicare users 24 .…”

Section: Discussionsupporting

confidence: 82%

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Hospitalizations in older‐adults newly diagnosed with dementia: A population‐based longitudinal study in Israel

Lutski

Shahar

Vered

et al. 2023

Int J Geriat Psychiatry

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Objectives: To compare inpatient burden (i.e. likelihood of hospitalization, number of admissions and length of stay) in persons with newly diagnosed dementia to the general population without dementia. Additionally, to evaluate whether inpatient burden is increased during the years prior to and post dementia diagnosis, and to identify factors associated with increased inpatient burden. Method:The Israeli National Dementia Dataset (2016) was cross-linked with the National Hospital Discharge Database of the Israeli Ministry of Health (2014)(2015)(2016)(2017)(2018). Dementia definition was based on documented dementia diagnoses and/or the purchase of medications during 2016. Mixed-effects models were applied to identify demographic and health characteristics associated with inpatient burden in the one and 2 years prior to and after dementia diagnosis. Results:The dataset included 11,625 individuals aged ≥65 years, identified as incident dementia cases. Compared to the general population of older-adults without dementia, those with newly diagnosed dementia had a higher agestandardized proportion of hospitalizations (26.4% vs. 40%). The odds for hospitalization were highest during the year preceding dementia diagnosis (OR = 3.19, 95% CI 2.51-4.06) compared to 2 years prior to diagnosis, and remained high (although slightly decreased) after dementia diagnosis. Older age was associated with inpatient burden after, but not prior to dementia diagnosis. Conclusions:Older persons with dementia are a vulnerable population group with increased utilization of inpatient burden compared to those without dementia, particularly in the years surrounding dementia diagnosis. Sociodemographic risk factors may differ with respect to the time surrounding dementia diagnosis.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 82%

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Hospitalizations in older‐adults newly diagnosed with dementia: A population‐based longitudinal study in Israel

Lutski

Shahar

Vered

et al. 2023

Int J Geriat Psychiatry

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“…This study is the first one to describe patterns of healthcare use before ADRD identification with an overall perspective of the healthcare use (hospital and non‐hospital care, drugs exposure, medical devices, institutionalization). To the best of our knowledge, all these aspects of healthcare use were either not previously considered together, 10,11,13,14,29 or not studied using MCA 12,15–18,30 . We found some researches studying only a portion of healthcare use using MCA but conducted in populations different from ours 31–35 .…”

Section: Discussionmentioning

confidence: 95%

“…A frequent late ADRD diagnosis is described 7,8 which may induce erratic healthcare trajectory, 9 sometimes due to a lack of regular and coordinated ambulatory care. If literature described healthcare use before ADRD identification, it mostly focused on a portion of healthcare use 10–17 (i.e. primary care, emergency room visits, hospitalization, home care).…”

Section: Introductionmentioning

confidence: 99%

Healthcare use patterns before Alzheimer's disease and related diseases identification and future healthcare trajectory

Couret

Lapeyre‐Mestre

Gombault‐Datzenko

et al. 2022

Int J Geriat Psychiatry

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Objectives A frequent late Alzheimer's Disease and Related Diseases (ADRD) identification is described and may induce erratic health resource use. We aimed to describe healthcare use patterns preceding ADRD identification. Methods We studied persons aged 65 or older, identified with incident ADRD in 2012 in the French health insurance database. Healthcare use covering a wide range of care in ambulatory and hospital settings during the period ranging from 18 to six months before ADRD identification was studied. The main dimensions of healthcare use patterns before ADRD identification were investigated in three age groups (65–74, 75–84, ≥85) through a multiple correspondence analysis. These dimensions were secondarily interpreted according to the 5‐year healthcare trajectory following ADRD identification, qualified as favorable (or not) by experts in the field. Results This research studied 36,990 subjects. Four dimensions raised in each age group. Two dimensions' interpretations were retrieved in all age groups: intensity of healthcare use, functional dependency. However, their rank differed along with the qualification of the future healthcare trajectory. Some specificities appeared in some age group. In the 65–74 and 75–84 years groups, there were dimensions reflecting healthcare use related to psychiatric or psycho‐behavioral disorders. In the ≥85 group, two dimensions reflected dependency related to other comorbidities, and organised medical follow‐up. Conclusion Several dimensions emerged in line with erratic trajectories before ADRD identification. They underlined the need for actions towards ADRD identification.

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The epidemiology of mild cognitive impairment, Alzheimer's disease and related dementia in U.S. veterans

Dinesh

Shao

Palnati

et al. 2023

Alzheimer's & Dementia

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IntroductionUS veterans have a unique dementia risk profile that may be evolving over time.MethodsAge‐standardized incidence and prevalence of Alzheimer's disease (AD), AD and related dementias (ADRD), and mild cognitive impairment (MCI) was estimated from electronic health records (EHR) data for all veterans aged 50 years and older receiving Veterans Health Administration (VHA) care from 2000 to 2019.ResultsThe annual prevalence and incidence of AD declined, as did ADRD incidence. ADRD prevalence increased from 1.07% in 2000 to 1.50% in 2019, primarily due to an increase in the prevalence of dementia not otherwise specified. The prevalence and incidence of MCI increased sharply, especially after 2010. The prevalence and incidence of AD, ADRD, and MCI were highest in the oldest veterans, in female veterans, and in African American and Hispanic veterans.DiscussionWe observed 20‐year trends of declining prevalence and incidence of AD, increasing prevalence of ADRD, and sharply increasing prevalence and incidence of MCI.

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[O5–03–02]: TRENDS IN HEALTH SERVICE USE AND POTENTIALLY AVOIDABLE HOSPITALIZATIONS PRIOR TO ALZHEIMER's DISEASE DIAGNOSIS: A MATCHED, RETROSPECTIVE STUDY OF U.S. MEDICARE BENEFICIARIES

Cited by 5 publications

References 0 publications

Hospitalizations in older‐adults newly diagnosed with dementia: A population‐based longitudinal study in Israel

Hospitalizations in older‐adults newly diagnosed with dementia: A population‐based longitudinal study in Israel

Healthcare use patterns before Alzheimer's disease and related diseases identification and future healthcare trajectory

The epidemiology of mild cognitive impairment, Alzheimer's disease and related dementia in U.S. veterans

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