Dementia and readmission risk in patients with heart failure participating in a transitional care program
Abstract
Background Cognitive impairment is prevalent in patients hospitalized for heart failure (HF). We aimed to generate further evidence on the value of dementia screening in hospitalized HF patients by examining whether and when dementia would be an independent risk factor for 30-day readmission while modeling permutations of known risk factors such as patient demographics, disease burden, prior utilization, and index hospitalization characteristics.Methods and results A retrospective cohort study was employed, consisting of 26,128 patients (2,075 or 7.9% with dementia) in a transitional care program post HF hospitalization. The overall 30-day all-cause readmission rate was 18.1%. Patients with dementia had higher unadjusted rates of readmission (22.0 vs 17.8%) and death (4.5 vs. 2.2%) within 30 days post hospitalization, compared to those without dementia. Hierarchical multivariable proportional hazards regression results showed that dementia independently predicted readmission when both patient demographics and disease burden variables were controlled for (HR=1.15, p=0.02). However, the association between dementia and readmission was attenuated in the full model when prior utilization and index hospitalization characteristics were added (HR=1.04, p=0.55). For dementia patients, Charlson comorbidity index, prior ED visits, and length of stay were significant risk factors of readmission.Conclusions The presence of dementia and the predictors of 30-day readmission in those with dementia may help identify this subset of high-risk HF patients for potential efforts to improve their prognosis.
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This reduced confidence in their ability to identify and diagnose dementia, subsequently limiting the extent to which discharge planning reflected the patient's care needs (CMOC8).
“This reduced confidence in their ability to identify and diagnose dementia, subsequently limiting the extent to which discharge planning reflected the patient’s care needs (CMOC8) [49, 50, 58, 79–82].”
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 [81]
This was linked to inadequate cognitive screening, poor documentation, and hospital readmission.
“This was linked to inadequate cognitive screening, poor documentation, and hospital readmission [49, 58, 79–82].”
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 [81]
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- Authors
- Lu, Y. Z., Huang, C.-W., Koyama, S., Taitano, M., Lee, E. A., Shen, E., & Nguyen, H. Q.
- Affiliations
- California State University, Long Beach (US)
- Kaiser Permanente (US)
- Corresponding author
- Nguyen, Huong Q.
- Venue
- Archives of Gerontology and Geriatrics
- Publisher
- Elsevier BV
- Published
- 2023-07
- Volume
- 110
- Pages
- 104973
- ISSN
- 0167-4943 (ISSN-L)
- OpenAlex
- W4321769460
- Cited by
- 5
- References
- 35
- Citations by year
- 2025: 2 · 2024: 3
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Archives of Gerontology and Geriatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- dementia, heart failure, 30-day readmission, care transitions, dementia screening, risk factors, Charlson Comorbidity Index, emergency department visits, length of hospital stay, mortality, cognitive impairment
- MeSH terms
- Transitional Care, Dementia, Heart Failure, Hospitalization, Humans, Patient Readmission, Retrospective Studies, Risk Factors
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