Hospitalization patterns among older patients with cancer with and without dementia.

Abstract

Objective: Cancer and dementia are prevalent chronic conditions among older adults. Despite the complexities involved in caring for individuals with both conditions, the patterns of hospitalization in this specific group are not well understood. This study aimed to examine the associations between the presence of dementia and hospitalization-related outcomes.

Study design: A multiyear cross-sectional analysis using 2016-2019 National Inpatient Sample data.

Methods: We examined hospitalization pattern disparities between patients with cancer 65 years and older with and without dementia at high risk of mortality. The influence of dementia on multiple hospitalization-related outcomes (eg, emergency admission, hospital charges) was investigated using a series of multivariable regression models.

Results: The study involved 774,812 hospital discharges of patients with cancer 65 years and older, including 8.7% with comorbid dementia. The prevalence of dementia varied across different cancer types, ranging from 5.5% for pancreatic cancer and esophageal cancer to 18.9% for nonmelanoma skin cancer. Multiple adjusted logistic regression models indicated that patients with cancer and dementia were more likely to be admitted through the emergency department (adjusted OR [AOR], 1.48; 95% CI, 1.44-1.52), to have nonelective admissions (AOR, 1.67; 95% CI, 1.61-1.74), and to be discharged to skilled nursing or related facilities (AOR, 2.16; 95% CI, 2.12-2.19), and they had approximately 6.9% lower hospital charges but a 6.8% longer length of stay compared with those without dementia (all  P  < .001).

Conclusions: Dementia was prevalent among older patients with cancer, particularly those with nonmelanoma, prostate, and bladder cancers. Comorbid dementia was associated with unplanned or unnecessary hospitalization, highlighting the need to enhance health care management and tailored strategies for this population.