Neuropsychiatric Disorders and Potentially Preventable Hospitalizations in a Prospective Cohort Study of Older Americans
Open accessAbstract
Background The relative contributions of depression, cognitive impairment without dementia (CIND), and dementia to the risk of potentially preventable hospitalizations in older adults are not well understood.Objective(s) To determine if depression, CIND, and/or dementia are each independently associated with hospitalizations for ambulatory care-sensitive conditions (ACSCs) and rehospitalizations within 30 days after hospitalization for pneumonia, congestive heart failure (CHF), or myocardial infarction (MI).Design Prospective cohort study.Participants Population-based sample of 7,031 Americans > 50 years old participating in the Health and Retirement Study (1998-2008).Main measures The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Primary outcomes were time to hospitalization for an ACSC and presence of a hospitalization within 30 days after hospitalization for pneumonia, CHF, or MI.Key results All five categories of baseline neuropsychiatric disorder status were independently associated with increased risk of hospitalization for an ACSC (depression alone: Hazard Ratio [HR]: 1.33, 95% Confidence Interval [95%CI]: 1.18, 1.52; CIND alone: HR: 1.25, 95%CI: 1.10, 1.41; dementia alone: HR: 1.32, 95%CI: 1.12, 1.55; comorbid depression and CIND: HR: 1.43, 95%CI: 1.20, 1.69; comorbid depression and dementia: HR: 1.66, 95%CI: 1.38, 2.00). Depression (Odds Ratio [OR]: 1.37, 95%CI: 1.01, 1.84), comorbid depression and CIND (OR: 1.98, 95%CI: 1.40, 2.81), or comorbid depression and dementia (OR: 1.58, 95%CI: 1.06, 2.35) were independently associated with increased odds of rehospitalization within 30 days after hospitalization for pneumonia, CHF, or MI.Conclusions Depression, CIND, and dementia are each independently associated with potentially preventable hospitalizations in older Americans. Older adults with comorbid depression and cognitive impairment represent a particularly at-risk group that could benefit from targeted interventions.
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Individuals with both dementia and depression had a 70% greater risk of preventable hospitalization than those without a neuropsychiatric disorder.
“Moreover, individuals with both dementia and depression had a 70% greater risk of preventable hospitalization than those without a neuropsychiatric disorder.790”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [790]
Based on data from the Health and Retirement Study and Medicare, after controlling for demographic variables, clinical characteristics, and health risk factors, individuals with dementia had a 30% greater risk of having a preventable hospitalization than those without a neuropsychiatric disorder.
“Based on data from the Health and Retirement Study (HRS) and Medicare, after controlling for demographic variables, clinical characteristics (e.g., presence of chronic medical conditions, number of hospitalizations in the prior year) and health risk factors, individuals with dementia had a 30% greater risk of having a preventable hospitalization than those without a neuropsychiatric disorder (that”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [790]
Based on data from the Health and Retirement Study (HRS) and Medicare, after controlling for demographic variables, clinical characteristics and health risk factors, individuals with dementia had a 30% greater risk of having a preventable hospitalization than those without a neuropsychiatric disorder.
“Based on data from the Health and Retirement Study (HRS) and Medicare, after controlling for demographic variables, clinical characteristics (e.g., presence of chronic medical conditions, number of hospitalizations in the prior year) and health risk factors, individuals with dementia had a 30% greater risk of having a preventable hospitalization than those without a neuropsychiatric disorder”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [950]
Individuals with both dementia and depression had a 70% greater risk of preventable hospitalization than those without a neuropsychiatric disorder.
“Moreover, individuals with both dementia and depression had a 70% greater risk of preventable hospitalization than those without a neuropsychiatric disorder. 950”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [950]
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- Authors
- Davydow, D. S., Zivin, K., Katon, W. J., Pontone, G. M., Chwastiak, L., Langa, K. M., & Iwashyna, T. J.
- Affiliations
- University of Washington (US)
- University of Michigan (US)
- Johns Hopkins University (US)
- Corresponding author
- Davydow, Dimitry S.
- ORCID
- Venue
- Journal of General Internal Medicine
- Published
- 2014-06-18
- Volume
- 29
- Issue
- 10
- Pages
- 1362-1371
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC4175651
- OpenAlex
- W2071535079
- Cited by
- 57
- References
- 49
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 7 · 2016: 9 · 2015: 7 · 2014: 1
- FWCI
- 6.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (U01 AG09740)
- Eli Lilly and Company
- Pfizer
- University of Michigan (U01 AG09740)
- National Institutes of Health (KL2TR000421)
- National Institute on Aging (U01 AG 09740, R01AG030155, U01AG009740)
- National Heart, Lung, and Blood Institute (K08HL091249)
- National Center for Advancing Translational Sciences
- 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
- neuropsychiatric disorders, depression, cognitive impairment without dementia, dementia, potentially avoidable hospitalizations, ambulatory care sensitive conditions, hospital readmission, pneumonia, congestive heart failure, myocardial infarction, older adults, comorbidities, health care utilization, Health and Retirement Study, Medicaid, long-term care, nursing homes, community-dwelling older adults
- MeSH terms
- Aged, Aged, 80 and over, Mental Disorders, Cognition Disorders, Dementia, Depression, Female, Hospitalization, Humans, Male, Prospective Studies, Risk Factors, United States, Cohort Studies
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