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. 2012 Jan 1;3(1):23-8.
doi: 10.1177/2150131911412783. Epub 2011 Sep 7.

Very mild dementia and medical comorbidity independently predict health care use in the elderly

Ellen Grober  1 , Amy Sanders, Charles B Hall, Amy R Ehrlich, Richard B Lipton
Affiliations

Very mild dementia and medical comorbidity independently predict health care use in the elderly

Ellen Grober et al. J Prim Care Community Health. .

Abstract

Objective: To determine whether dementia status and medical burden were independent predictors of emergency department (ED) visits and hospitalizations in older patients from an urban geriatric practice participating in a primary care based cognitive screening program.

Participants and methods: A comprehensive chart review was conducted for 300 African American and Caucasian patients, including 46 with prevalent dementia and 28 with incident dementia using the Cumulative Illness Burden Scale. Hospital-based claims data was used to retrieve ED visits and hospital admissions for 5 years following baseline assessment.

Results: Patients with dementia had a 49% higher rate of ED visits (IRR = 1.49; 95% CI = 1.06, 2.09) and an 83% higher risk of death than patients without dementia (HR = 1.83; 95% CI = 3.07, 0.03). Dementia status predicted hospital admissions after adjustment for medical burden (IRR = 1.37; 95% CI = 0.99, 1.89). For each one point increase in medical burden, there was an 11% increase in ED visits (IRR = 1.11; 95% CI = 1.06, 1.16), a 13% increase in hospital admissions (IRR = 1.13; 95% CI = 1.09, 1.17), and an 11% higher risk of death (HR = 1.11; 95% CI = 1.04, 1.17). Age did not predict utilization.

Conclusion: Dementia status and medical burden were independent predictors of ED visits and death in patients with clinically diagnosed dementia followed from the early stage of disease.

Keywords: acute care utilization; dementia; emergency department visits; hospitalizations; primary care.

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Conflict of interest statement

Declaration of Conflicting Interests

The authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

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