Trajectory of cardiometabolic disease‐related hospitalizations before and after dementia diagnosis
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Dementia is associated with increased healthcare use, though the timing of hospitalizations in relation to the development of dementia remains unclear. Cardiometabolic diseases (CMDs) including type 2 diabetes, heart disease, and stroke often co-occur with dementia, but the impact of dementia on CMD-related hospitalizations remains unknown. We aimed to map the trajectory of CMD-related hospitalization before and after dementia diagnosis and to further identify factors of CMD-related hospitalization. METHOD: Within the Swedish Twin Registry, 1657 participants aged ≥65 (58.8% women) with incident dementia were matched with 1657 dementia-free participants using propensity scores. Participants were followed for up to 20 years to detect CMD-related hospitalizations. Dementia and CMD-related hospitalizations (planned and unplanned) were identified from medical records. Factors of CMD-related hospitalizations included age, sex, education, marital status, smoking, drinking, physical activity, body mass index, and hypertension. Data were analyzed using Poisson regression and generalized estimating equation models. RESULT: Compared to the controls, the incidence of CMD-related hospitalization among people with dementia started to increase from 4 years before (incidence rate ratio [IRR] 1.25, 95% confidence interval [CI] 1.00-1.57) and started to decrease 3 years after, the diagnosis (IRR 0.74, CI 0.58-0.94). People with dementia had a greater number of CMD-related hospitalizations (IRR 1.16, CI 1.04-1.30), longer hospital stays (IRR 1.19, CI 1.04-1.56), and higher 30-day readmissions (IRR 1.27, CI 1.04-1.56) in the five years before dementia diagnosis, but these rates decreased after the diagnosis. Male sex, smoking, obesity, and hypertension were associated with further increases in CMD-related hospitalization among people with dementia. CONCLUSION: CMD-related hospitalization changes over the course of dementia development. Our findings suggest that the healthcare burden increases even before the diagnosis of dementia, and CMD-related hospitalization may be an early sign of the future onset of dementia.
Source: Alzheimer s & Dementia
Author: Sakura Sakakibara
Institution: Karolinska Institutet
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7116899015
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