Unfortunately, for those who develop dementia later in life, it seems as though hospitalization is par for the course. A recent study found that dementia was associated with higher hospitalization rates in patients 65 and older, and disappointingly, a generous bunch of those admissions could have been prevented with better outpatient care.
The study: Elizabeth A. Phelan, MD, MS, of the University of Washington in Seattle, and colleagues reported that all-cause admissions rose 41% with incident dementia compared with others 65 or older in the same integrated healthcare system after adjustment for other factors (P<0.001). The hospitalizations that could have been prevented (for instance, hospitalization for urinary tract infections) were a whopping 78% more common with dementia patients (P<0.001) in the fully adjusted results appearing in the January 11 issue of the Journal of the American Medical Association.
What this means: Overall, 86% of seniors with dementia went to the hospital at least once compared with 59% of those without dementia. Trivial admissions for dementia sufferers aren’t so trivial for them. Complications that develop in the hospital, such as pressure ulcers or delirium, reduce their quality of life and can keep them from being discharged. Dementia patients are already an at-risk group and usually possess more comorbidities and more prescriptions than others their age. Worsening of those problems only speeds up their decline.
The study wasn’t able to determine how many of the potentially preventable admissions truly were preventable, however, the results show a need for improvement in “anticipatory, proactive primary care” for those suffering from dementia.
Constantine G. Lyketsos, MD, MHS, of Johns Hopkins, noted in an accompanying editorial:
“Effective ambulatory care that prevents hospitalizations through proactive dementia detection and management is a major and realistic priority in the public health response to dementia,”
Phelan summarized her whole point by saying:
“If we could avoid hospitalizations for this population subgroup in the first place, patients would be better off,”
Do you have a relative who suffers from dementia?