Hospital admission risk in community dwelling elderly dementia subjects

Background/Objective: To examine the frequency of hospitalization and old age home placement in a cohort of community-dwelling elderly patients with mild to moderate dementia and to describe the principal diagnosis for admission and evaluate risk factors for hospitalization. Methods: Prospective cohort of new cases attending memory clinics of 3 regional hospitals was followed up for 1 year with record of acute hospital admission and nursing home placement. Incidence of acute hospital admission were recorded from the territory-wise electronic record system. Risk factors variables including demographics, co-morbidity as measured by Charlson comorbidity index CCI and diagnoses were retrieved. Results: Among 267 eligible elderly with a mean age of 79.97 (SD 15.96) and 86 (32.7%) male were included. During the 1 year follow up, 96 (36%) were hospitalized at least once. Among them 41 (42.7%) were hospitalized 2 or more times with a median duration of hospital stay of 3 days per person year. The 5 leading reasons for hospitalization were sepsis (22.2%), neurological problem (17.5%), fall (12.7%), cardiac problem (7.9%) and GI disorder (6.3%). The only significant predictors for hospitalization were age (OR 1.11, 95% CI 1.06, 1.17) and CCI (OR 1.34, 95% CI 1.08, 1.67). Among those who have been hospitalized, 4 out of 10 were discharged directly to old age home. Compared with those who have not been hospitalized, 10% of the ever hospitalized subjects will be send to old age home subsequently within 1 year (0 vs. 10%, p < 0.001). Conclusion: In community-dwelling dementia outpatients, acute hospitalization occurred in one third of patients over a period of 1 year and 10% of them will subsequently be placed in old age home. With these results, clinicians may be able to identify dementia patients at risk of hospitalization. Author Contributions: Dr DKY Miu is responsible for literature search, protocol, data collection, statistical analysis and preparation of manuscript. Dr KM Lo and Dr Stanley Tam are responsible for data collection and preparation of the manuscript. 2210-8335/Copyright (c) 2018, Asia Pacific League of Clinical Gerontology & Geriatrics. Published by Full Universe Integrated Marketing Limited.