Hospitalization in Community‐Dwelling Persons with Alzheimer's Disease: Frequency and Causes
Open accessAbstract
OBJECTIVES: To examine the rates of and risk factors for acute hospitalization in a prospective cohort of older community‐dwelling patients with Alzheimer's disease (AD). DESIGN: Longitudinal patient registry. SETTING: AD research center. PARTICIPANTS: Eight hundred twenty‐seven older persons with AD. MEASUREMENTS: Acute hospitalization after AD research center visit was determined from a Medicare database. Risk factor variables included demographics, dementia‐related, comorbidity and diagnoses and were measured in interviews and according to Medicare data. RESULTS: Of the 827 eligible patients seen at the ADRC during 1991 to 2006 (median follow‐up 3.0 years), 542 (66%) were hospitalized at least once, and 389 (47%) were hospitalized two or more times, with a median of 3 days spent in the hospital per person‐year. Leading reasons for admission were syncope or falls (26%), ischemic heart disease (17%), gastrointestinal disease (9%), pneumonia (6%), and delirium (5%). Five significant independent risk factors for hospitalization were higher comorbidity (hazard ratio (HR)=1.87, 95% confidence interval (CI)=1.57–2.23), previous acute hospitalization (HR=1.65, 95% CI=1.37–1.99), older age (HR=1.51, 95% CI=1.26–1.81), male sex (HR=1.27, 95% CI=1.04–1.54), and shorter duration of dementia symptoms (HR=1.26, 95% CI=1.02–1.56). Cumulative risk of hospitalization increased with number of risk factors present at baseline: 38% with zero factors, 57% with one factor, 70% with two or three factors, and 85% with four or five factors ( P trend <.001). CONCLUSION: In a community‐dwelling population with generally mild AD, hospitalization is frequent, occurring in two‐thirds of participants over a median follow‐up time of 3 years. With these results, clinicians may be able to identify dementia patients at high risk for hospitalization.
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The most common reasons that people with Alzheimer's dementia are hospitalized are not due to the disease itself, but include syncope, fall and trauma (26%), ischemic heart disease (17%), and gastrointestinal disease (9%).
“The most common reasons that people with Alzheimer's dementia are hospitalized are not due to the disease itself, but for other reasons, including syncope (fainting), fall and trauma (26%), ischemic heart disease (17%), and gastrointestinal disease (9%), 870”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [870]
The Abstract Results report syncope or falls (26%), ischemic heart disease (17%), and gastrointestinal disease (9%) as leading admission reasons. The Abstract Conclusion limits the findings to community-dwelling people with generally mild Alzheimer’s disease, rather than people with Alzheimer’s dementia generally. The cited passages also do not identify trauma separately within the 26% category. (LLM, conf=0.86)
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- Authors
- Rudolph, J. L., Zanin, N. M., Jones, R. N., Marcantonio, E. R., Fong, T. G., Yang, F. M., Yap, L., & Inouye, S. K.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2010-08
- Volume
- 58
- Issue
- 8
- Pages
- 1542-1548
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC2955171
- OpenAlex
- W2104113189
- Cited by
- 203
- References
- 45
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 16 · 2023: 14 · 2022: 12 · 2021: 13 · 2020: 16 · 2019: 25 · 2018: 13 · 2017: 14 · 2016: 14 · 2015: 16 · 2014: 12 · 2013: 10 · 2012: 13
- FWCI
- 5.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (T35AG026781, R03AG029861, K24AG000949, P50AG005134, P30AG062421)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- Alzheimer's disease, hospitalization, community-dwelling older adults, risk factors, comorbidities, falls, syncope, delirium, pneumonia, ischemic heart disease, mild cognitive impairment, hospital readmission
- MeSH terms
- Accidental Falls, Age Factors, Aged, Alzheimer Disease, Delirium, Female, Gastrointestinal Diseases, Hospitalization, Humans, Longitudinal Studies, Male, Massachusetts, Pneumonia, Prospective Studies, Registries, Risk Factors, Sex Factors, Syncope, Comorbidity, Myocardial Ischemia
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