Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia
Abstract
Objectives: The aim of this study was to investigate the principal discharge diagnosis and related comorbidity in hospitalized older patients affected by dementia. Methods: Data from 51,838 consecutive computerized discharge records of the St. Anna University Hospital (Ferrara, Italy) were analyzed. Records included only subjects aged ≥60 years. Number of admissions, length of stay in hospital, primary and secondary discharge diagnosis (by ICD‐9‐CM code), number of procedures, and possible death were evaluated. Results: Demented patients represented 8.6% of the sample (4466 individuals) and were older and more likely to be female patients compared with controls (47,372 individuals); they were characterized by higher number of admissions to hospital, instrumental clinical investigations, secondary diagnoses, and mortality rate. Among the primary diagnoses, a higher prevalence of cerebrovascular disease, pneumonia, and hip fracture was observed in demented patients. Furthermore, pulmonary embolism, renal failure, septicemia, and urinary infections were frequently reported in demented patients, but not in controls. As regards secondary diagnoses, dementia was associated with an increased risk of delirium, muscular atrophy and immobilization, dehydration, cystitis, and pressure ulcers, whereas the risk for other conditions, including cancer, was reduced. Conclusions: Among older patients, dementia was associated with higher rate of admissions to hospital and mortality. Discharge diagnoses were sensibly different according to the presence of dementia; in particular, a greater load and a different kind of comorbidity were observed in demented patients. On the whole, our data suggest that the adequate management of demented outpatients might help to reduce hospitalization. Copyright © 2011 John Wiley & Sons, Ltd.
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When healthcare professionals assumed patients with MLTCiD were unable to participate in rehabilitation or educational programmes, referrals were reduced.
“When HCPs assumed patients with MLTCiD were unable to participate in rehabilitation or educational programmes, referrals were reduced, which limited access to supportive services despite evidence of potential benefits (CMOC12) [49, 53, 88, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [89]
Reduced referrals limited access to supportive services despite evidence of potential benefits.
“When HCPs assumed patients with MLTCiD were unable to participate in rehabilitation or educational programmes, referrals were reduced, which limited access to supportive services despite evidence of potential benefits (CMOC12) [49, 53, 88, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [89]
Older adults with dementia typically stay longer in hospital.
“Analysis suggested that pressure to comply with the system-level focus on occupancy targets and minimising length of stay further fuelled these beliefs, as older adults with dementia typically stay longer in hospital [41, 43, 48, 50, 75, 78, 84, 89, 91–93].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [89]
Pressure to comply with the system-level focus on occupancy targets and minimising length of stay further fuelled healthcare professionals' beliefs about patients with MLTCiD.
“Analysis suggested that pressure to comply with the system-level focus on occupancy targets and minimising length of stay further fuelled these beliefs, as older adults with dementia typically stay longer in hospital [41, 43, 48, 50, 75, 78, 84, 89, 91–93].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [89]
Literature included the use of non-standardised terminology or non-compliance with labelling medical records to indicate dementia.
“Literature included the use of non-standardised terminology, (e.g., ‘confusion’, ‘cognitive impairment’) or non-compliance with labelling medical records to indicate dementia [45, 50, 79, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [89]
Healthcare professionals working outside of geriatric care were often unaware of dementia diagnoses.
“As a result, HCPs working outside of geriatric care were often unaware of dementia diagnoses (CMOC14) [50, 53, 59, 66, 79, 86, 89].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [89]
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- Authors
- Zuliani, G., Galvani, M., Sioulis, F., Bonetti, F., Prandini, S., Boari, B., Guerzoni, F., & Gallerani, M.
- Affiliations
- University of Ferrara (IT)
- Arcispedale Sant'Anna (IT)
- Corresponding author
- Zuliani, Giovanni
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2011-04-27
- Volume
- 27
- Issue
- 3
- Pages
- 313-320
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W1789334989
- Cited by
- 54
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 6 · 2013: 10 · 2012: 3
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- dementia, older adults, hospitalization, hospital discharge diagnoses, comorbidities, hospital readmission, mortality, cerebrovascular disease, pneumonia, hip fracture, delirium, pressure ulcers, urinary tract infection, length of hospital stay
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Hospitalization, Hospitals, University, Humans, Italy, Length of Stay, Male, Patient Discharge, Comorbidity, Prevalence, Odds Ratio, Hospital Mortality
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