Dementia Hospitalizations Increasing

Dementia patients hospitalized despite no quality of life improvement

November 27, 2011 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Even though the the rapidly growing over 85 age group represents only 2 percent of the U.S. population, they represent 40 percent of all hospitalizations associated with dementia.

By 2050, the number of patients over 85 years old is expected to increase to 4 percent, potentially resulting in a dramatic increase in the number of hospitalized elderly dementia patients.

"Talk to your relatives early about their wishes for dementia care."

Dr. Marya Zilberberg with the EviMed Research Group's department of epidemiology conducted the research in dementia-associated hospitalizations among patients over the age of 85 to gain a better understanding of its implications in planning future health care policies.

During the study researchers obtained data on all hospitalizations involving a dementia diagnosis in patients 85 and older between 2000 and 2008. The data came from a nationally representative Nationwide Inpatient Sample database, a part of the Agency for Healthcare Research and Quality Healthcare Costs and Utilization Project. Population estimates and predication data also was obtained from the U.S. Census Bureau.

Investigators found that the number of hospitalizations among patients over 85 increased from 700,000 in 2000 to 1.2 million during the study's final year. In static projections, they estimate that by 2050 between 3 million to 4 million dementia patients over the age of 85 could be hospitalized each year.

Using a dynamic prediction model suggested that there could be more than 7 million older patient dementia hospitalizations in 2050-- a 10-fold increase over 2000.

"Even at its minimum, the absolute growth in hospitalizations involving a dementia diagnosis is alarming in that without planning, the growth in hospitalizations may well overwhelm a health care system already under strain," Dr. Zilberberg said. "In addition, humanistic considerations dictate that this degree of aggressive care may be inappropriate for many patients with dementia."

She referenced a recent study that found that 18.7 percent of nursing home residents with advanced dementia were hospitalized near end of life. Dr. Zilberberg stressed that such hospitalizations could represent an intrusive burden more than a desirable intervention, and urged the development of facilities equipped to care for elderly patients with advanced dementia.

The study was recently published in the Archives of Internal Medicine.