P1‐251: Hospitalization and incident MCI and Alzheimer's dementia in community‐dwelling older adults
Year: 2015
Type: article
Study design: Observational Study
Abstract: Hospitalization has been associated with cognitive impairment in older persons but it is not clear whether hospitalization is a risk factor for Alzheimer's disease (AD) dementia. We tested the hypothesis that hospitalization is associated with risk of developing mild cognitive impairment (MCI) and AD dementia in older adults. Annual cognitive assessments were linked to Medicare claims records for older persons enrolled in the Rush Memory and Aging Project with no cognitive impairment at baseline, providing information on hospitalization and cognitive change for up to 11 years. Diagnosis of AD dementia followed NINCDS/ADRDA criteria; diagnosis of MCI was rendered if impaired but did not meet criteria for dementia. The association of hospitalization and incident AD dementia and MCI were tested in Cox proportional hazards models adjusted for age sex and education. Hospitalization was treated as time-varying such that person-years for hospitalized participants were separated into non-hospital (up to hospitalization) and post-hospital (after hospitalization) person-years. Among 984 participants with at least 2 annual assessments followed for a mean of 5.8 (SD=3.3) years, 612 (62%) were hospitalized at least once, 370 (51%) developed MCI and 244 (25%) developed AD dementia. The initial hospitalization lasted for a mean of 4.1 days (SD=3.3) with a mean Charlson Comorbidity Index of 0.9 (SD=1.0); it was preceded by a mean of 2.4 years of observation (SD=2.0) and followed by a mean of 3.9 years (SD=3.1). Hospitalization was associated with an increased risk for MCI (hazard ratio [HR]=1.56, 95% confidence interval [CI]=1.18, 2.06) and AD dementia (HR=1.89, CI=1.30, 2.75). Hospitalizations were associated with incidence of MCI and dementia in community-dwelling older adults. More work is necessary to determine the mechanisms underlying this relationship and specific hospitalization procedures that could be most harmful.
Source: Alzheimer s & Dementia
Authors: Bryan D. James, Robert S. Wilson, Raj C. Shah, Patricia A. Boyle, E. Wesley Ely, Xuejie James Zhang, Theodore J. Iwashyna, David A. Bennett, Julie A. Schneider
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2327632482