Impact of dementia on outcomes in older patients with COVID-19: A nationwide inpatient sample analysis

IF 1.8 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing Pub Date : 2025-09-08 DOI:10.1111/ajag.70082

Ruoh Lih Lei, Wei-Min Chu, Tsu-Yin Wu, Su Chen Yu, Hsiu-Min Tsai, Ju-Lan Yang, Shih-Chia Liu

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引用次数: 0

Abstract

Objective

Although existing evidence suggests a potential link between dementia and adverse outcomes in patients with COVID-19, a definitive relationship is uncertain. This study aimed to evaluate the impact of dementia on in-hospital outcomes of patients in the presence of COVID-19.

Methods

The US Nationwide Inpatient Sample (NIS) was searched for patients 65 years or older hospitalised for COVID-19 in 2020. Patients were categorised into those with and without dementia before COVID-19 infection. Outcomes included in-hospital mortality, discharge to long-term care, length of stay (LOS), total hospital costs and complications. Propensity score matching (PSM) was used to balance the baseline characteristics between the groups. Regression analyses were performed to assess the associations between dementia and outcomes.

Results

After PSM, 42,214 patients were included, with equal distribution of most study variables between groups. Dementia was associated with increased in-hospital mortality (adjusted odds ratio [aOR] = 1.17, 95% confidence interval [CI]: 1.11–1.23), discharge to long-term care facilities (aOR = 4.0, 95% CI: 3.8–4.2), occurrence of any complications (aOR = 1.33, 95% CI: 1.27, 1.38), 1.12 days longer LOS (95% CI: .93–1.31) and 2.68 thousand USD higher total hospital costs (95% CI: .72–4.64). For specific complications, dementia was associated with significantly increased risks of acute respiratory distress syndrome (aOR = 1.19, 95% CI: 1.14–1.24) encephalitis, myelitis and encephalomyelitis (aOR = 4.60, 95% CI: 1.33–15.93), as well as delirium, respiratory failure and acute kidney injury.

Conclusion

Dementia is associated with worse outcomes of older patients with COVID-19.

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查看原文本刊更多论文

痴呆症对老年COVID-19患者预后的影响：一项全国住院患者样本分析

尽管现有证据表明，COVID-19患者的痴呆与不良后果之间存在潜在联系，但明确的关系尚不确定。本研究旨在评估痴呆症对COVID-19患者住院预后的影响。方法检索2020年美国全国住院患者样本（NIS）中65岁及以上因COVID-19住院的患者。患者被分为感染COVID-19之前患有和未患有痴呆症的患者。结果包括住院死亡率、出院接受长期护理、住院时间（LOS）、总住院费用和并发症。使用倾向评分匹配（PSM）来平衡各组之间的基线特征。进行回归分析以评估痴呆与预后之间的关系。结果PSM后纳入42214例患者，大部分研究变量在组间分布均匀。痴呆与住院死亡率增加（调整优势比[aOR] = 1.17, 95%可信区间[CI]: 1.11-1.23）、出院到长期护理机构（aOR = 4.0, 95% CI: 3.8-4.2）、任何并发症的发生（aOR = 1.33, 95% CI: 1.27, 1.38）、住院时间延长1.12天（95% CI: 0.93 - 1.31）和住院总费用增加2.68万美元（95% CI: 0.72 - 4.64）相关。对于特定并发症，痴呆与急性呼吸窘迫综合征（aOR = 1.19, 95% CI: 1.14-1.24）、脑炎、脊髓炎和脑脊髓炎（aOR = 4.60, 95% CI: 1.33-15.93）以及谵妄、呼吸衰竭和急性肾损伤的风险显著增加相关。结论老年COVID-19患者预后较差与痴呆相关。

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来源期刊

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.