Affiliations: [a]
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| [b]
Stockholm Gerontology Research Center, Stockholm, Sweden
| [c]
Department of Epidemiology & Biostatistics, Public Health School, Tianjin Medical University, China
Correspondence:
[*]
Correspondence to: Clément Pimouguet, PhD, Aging Research Center, Karolinska Institutet, Gävlegatan
16, S-113 30 Stockholm, Sweden. Tel.: +46 8 6905848; Fax: +46 8 690 6889; E-mail: clement.pimouguet@ki.se and Weili Xu, MD, PhD, Associate Professor, Department of Epidemiology & Biostatistics, Tianjin Medical University, China, Aging Research Center, Karolinska Institutet, Gävlegatan 16, S-113 30 Stockholm, Sweden. Tel.: +46 8 6905848; Fax: +46 8 6906889; E-mail: weili.xu@ki.se.
Abstract: Background: Studies have reported that moderate/severe stages of dementia are linked to increased hospitalization rates, but little is known about the influence of incipient dementia on hospitalizations for primary care sensitive conditions (PCSCs). Objective: To examine the associations between incipient dementia and hospitalization outcomes, including all-cause and PCSC hospitalization. Methods: A total of 2,268 dementia-free participants in the Swedish National study on Aging and Care-Kungsholmen were interviewed and clinically examined at baseline. Participants aged ≥78 years were followed for 3 years, and those aged 60–72 years, for 6 years. Number of hospitalizations was retrieved from the National Patient Register. Dementia was diagnosed in accordance with Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Hospitalization outcomes were compared in participants who did and did not develop dementia. Zero-inflated Poisson regressions and logistic regressions were used in data analysis. Results: During the follow-up, 175 participants developed dementia. The unadjusted PCSC admission rate was 88.2 per 1000 person-years in those who developed dementia and 25.6 per 1000 person-years in those who did not. In the fully adjusted logistic regression model, incipient dementia was associated with an increased risk of hospitalization for PCSCs (OR = 2.3, 95% CI 1.3–3.9) but not with the number of hospitalizations or with all-cause hospitalization. Risks for hospitalization for diabetes, congestive heart failure, and pyelonephritis were higher in those who developed dementia than in those who did not. About 10% participants had a PCSC hospitalization attributable to incipient dementia. Conclusion: People with incipient dementia are more prone to hospitalization for PCSCs but not to all-cause hospitalization.
Keywords: Dementia, hospitalization longitudinal follow-up, population based study
