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• W2020257589 abstract "Acute care hospitalization poses particular risks for persons with dementia and comorbid illness, including increased hospital stays and poor outcomes following discharge. Our aim was to identify the risk (and associated determinants) of hospitalization and outcomes following discharge (e.g., death, re-hospitalization, transfer to long-term care) among older residents of Assisted Living (AL) facilities, comparing those with and without dementia. Among 1,066 AL residents aged 65+ (from 59 facilities) participating in the Alberta Continuing Care Epidemiologic Studies (ACCES), 57% (609) had a diagnosis of dementia. Research nurses completed inter RAI -AL resident assessments and interviewed family caregivers at baseline and 1-year (including discharge/decedent interviews). Hospitalization events were determined via linkage with the provincial discharge abstract database. Key predictors were examined using multivariate Cox proportional hazards regression models (with adjustment for clustering and competing risks). Residents with dementia were significantly older and more likely to have poor social relationships and activity levels, depression, cognitive and functional impairment, multi-morbidity, and aggression than residents without dementia. Conversely, they were less likely to be using multiple drugs or to experience a hospitalization (in the year prior- and post- baseline assessment). The adjusted HR for hospitalization among residents with dementia was 0.99 (95%CI 0.79-1.26). However when hospitalized, residents with dementia had longer hospital and ALC bed stays (220 events: median 14 days, total bed days=6488) than those without dementia (193 events: median 10 days, total bed days=3903). Following hospital discharge, those with dementia were significantly more likely to be admitted to long-term care (31% v. 12%) and less likely to be re-hospitalized (16% v. 36%) during follow-up (mortality rates during and post-hospitalization did not vary significantly between the 2 groups). Older AL residents with and without dementia showed a comparable risk of first event hospitalization. However, residents with dementia were more likely to have longer total and ALC bed stays when hospitalized, possibly increasing their risk for functional decline. Their lower risk of re-hospitalization (concurrent with their increased risk for long-term care placement) following hospital discharge supports the notion that admission to a nursing home may lead to a reduction in hospital use." @default.
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• W2020257589 date "2014-07-01" @default.
• W2020257589 modified "2023-09-27" @default.
• W2020257589 title "P3-285: ACUTE CARE TRANSITIONS AND OUTCOMES AMONG ASSISTED LIVING RESIDENTS WITH AND WITHOUT DEMENTIA" @default.
• W2020257589 doi "https://doi.org/10.1016/j.jalz.2014.05.1377" @default.
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