Halima Amjad, Vishaldeep K Sekhon, Jennifer L Wolff, Quincy M Samus, David L Roth
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Persons undiagnosed or unaware experienced outcomes similar to persons aware and diagnosed except for more 30-day readmissions in the undiagnosed (adjusted odds ratio [95% confidence interval] 2.05 [1.01, 4.16]).</p><p><strong>Discussion: </strong>Persons undiagnosed or unaware of dementia experience worse hospitalization outcomes, suggesting potential clinically significant implications of unrecognized dementia.</p><p><strong>Highlights: </strong>Persons with undiagnosed versus no dementia have worse hospitalization outcomes.Persons with undiagnosed dementia have more 30-day readmissions compared to persons diagnosed.Lack of clinician or family recognition of dementia may adversely affect hospitalization outcomes.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 1","pages":"e70051"},"PeriodicalIF":4.0000,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736704/pdf/","citationCount":"0","resultStr":"{\"title\":\"Hospitalization outcomes among older adults living undiagnosed or unaware of dementia.\",\"authors\":\"Halima Amjad, Vishaldeep K Sekhon, Jennifer L Wolff, Quincy M Samus, David L Roth\",\"doi\":\"10.1002/dad2.70051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Many persons with dementia are undiagnosed or unaware of dementia, which may affect hospitalization outcomes.</p><p><strong>Methods: </strong>We evaluated differences in length of stay, days not at home, discharge destination, and 30-day readmissions over 1 year in 6296 older adults in the National Health and Aging Trends Study with linked Medicare claims. Multivariable-adjusted models compared outcomes across no dementia, undiagnosed dementia, unaware but diagnosed with dementia, and aware and diagnosed with dementia.</p><p><strong>Results: </strong>Persons with undiagnosed dementia had longer length of stay and were more likely to be discharged to a facility (44.8% vs. 19.3%) compared to no dementia; differences persisted in multivariable models. Persons undiagnosed or unaware experienced outcomes similar to persons aware and diagnosed except for more 30-day readmissions in the undiagnosed (adjusted odds ratio [95% confidence interval] 2.05 [1.01, 4.16]).</p><p><strong>Discussion: </strong>Persons undiagnosed or unaware of dementia experience worse hospitalization outcomes, suggesting potential clinically significant implications of unrecognized dementia.</p><p><strong>Highlights: </strong>Persons with undiagnosed versus no dementia have worse hospitalization outcomes.Persons with undiagnosed dementia have more 30-day readmissions compared to persons diagnosed.Lack of clinician or family recognition of dementia may adversely affect hospitalization outcomes.</p>\",\"PeriodicalId\":53226,\"journal\":{\"name\":\"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring\",\"volume\":\"17 1\",\"pages\":\"e70051\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-01-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736704/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/dad2.70051\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/dad2.70051","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Hospitalization outcomes among older adults living undiagnosed or unaware of dementia.
Introduction: Many persons with dementia are undiagnosed or unaware of dementia, which may affect hospitalization outcomes.
Methods: We evaluated differences in length of stay, days not at home, discharge destination, and 30-day readmissions over 1 year in 6296 older adults in the National Health and Aging Trends Study with linked Medicare claims. Multivariable-adjusted models compared outcomes across no dementia, undiagnosed dementia, unaware but diagnosed with dementia, and aware and diagnosed with dementia.
Results: Persons with undiagnosed dementia had longer length of stay and were more likely to be discharged to a facility (44.8% vs. 19.3%) compared to no dementia; differences persisted in multivariable models. Persons undiagnosed or unaware experienced outcomes similar to persons aware and diagnosed except for more 30-day readmissions in the undiagnosed (adjusted odds ratio [95% confidence interval] 2.05 [1.01, 4.16]).
Discussion: Persons undiagnosed or unaware of dementia experience worse hospitalization outcomes, suggesting potential clinically significant implications of unrecognized dementia.
Highlights: Persons with undiagnosed versus no dementia have worse hospitalization outcomes.Persons with undiagnosed dementia have more 30-day readmissions compared to persons diagnosed.Lack of clinician or family recognition of dementia may adversely affect hospitalization outcomes.
期刊介绍：
Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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