Emergency and post‐emergency care of older adults with Alzheimer's disease/Alzheimer's disease related dementias
Open accessAbstract
Background: The emergency department (ED) is a critical juncture in the care of persons living with dementia (PLwD), as they have a high rate of hospital admission, ED revisits, and subsequent inpatient stays. We examine ED disposition of PLwD compared with older adults with non‐dementia chronic disease as well as healthcare utilization and survival. Methods: Medicare claims data were used to identify community‐dwelling older adults 66+ years old from 34 hospitals with either Alzheimer's disease/Alzheimer's disease related dementias (AD/ADRD) or a non‐AD/ADRD chronic condition between January 1, 2014, and December 31, 2018. We compared ED disposition at the index visit, as well as healthcare utilization and mortality in the 12 months following an index ED visit, and adjusted for age, gender, and risk of mortality. Results: There were 29,626 patients in the AD/ADRD sample, and 317,046 in the comparison sample. The AD/ADRD sample was older (82.4 years old [SD: 8.2] vs. 76.0 years old [SD: 7.7]) and had more female patients (59.9% vs. 54.7%). The AD/ADRD sample was more likely to experience ED disposition to acute care (OR 1.039, p < 0.001, 95% CI 1.029–1.050), to have an ED revisit (OR 1.077, p < 0.001, 95% CI 1.066–1.087), and an inpatient stay in the subsequent 12 months (OR 1.085, p < 0.001, 95% CI 1.075–1.095). ED disposition to hospice was low in both samples (0.2%). AD/ADRD patients had a higher risk of mortality (OR 1.099, p < 0.001, 95% CI 1.091–1.107) and high short‐term mortality (31.9% within 12 months) than those without AD/ADRD (15.3% within 12 months). Conclusions: PLwD who visit the ED have high short‐term mortality. Despite this, disposition to acute care, ED revisits, and inpatient stays, rather than hospice, remain the predominant mode of care delivery. Transition directly from the ED to hospice for PLwD is rare.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Individuals with Alzheimer's or another dementia seen in the emergency department are more likely to be admitted to the hospital or a nursing home from the emergency department than Medicare beneficiaries without Alzheimer's or other dementias.
“One group of researchers found that individuals with Alzheimer's or another dementia seen in the emergency department are more likely to be admitted to the hospital or a nursing home from the emergency department than Medicare beneficiaries without Alzheimer's or other dementias. 875”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [875]
Individuals with Alzheimer's or other dementias are more likely to have at least one hospitalization, have at least one subsequent emergency department visit, and be admitted to hospice in the 12 months following the initial emergency department visit.
“Additionally, individuals with Alzheimer's or other dementias are more likely to have at least one hospitalization, have at least one subsequent emergency department visit and be admitted to hospice in the 12 months following the initial emergency department visit.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [875]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Appelhof, B., Bakker, C., den IJssel, J. C. L. V. D., Zwijsen, S. A., Smalbrugge, M., Verhey, F. R. J., de Vugt, M. E., Zuidema, S. U., & Koopmans, R. T. C. M. (2017) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000477087 · Cited by 2,773 · see citing works
Alzheimer disease in the United States (2010–2050) estimated using the 2010 census
Hebert, L. E., Weuve, J., Scherr, P. A., & Evans, D. A. (2013) · Neurology · doi:10.1212/wnl.0b013e31828726f5 · Cited by 2,642 · see citing works
A combined comorbidity score predicted mortality in elderly patients better than existing scores
Gagne, J. J., Glynn, R. J., Avorn, J., Levin, R., & Schneeweiss, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.10.004 · Cited by 995 · see citing works
Amjad, H., Roth, D. L., Sheehan, O. C., Lyketsos, C. G., Wolff, J. L., & Samus, Q. M. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-018-4377-y · Cited by 506 · see citing works
Economic burden of Alzheimer disease and managed care considerations
Winston Wong, P. (2020) · The American Journal of Managed Care · doi:10.37765/ajmc.2020.88482 · Cited by 408 · see citing works
Forecasting the prevalence of preclinical and clinical Alzheimer's disease in the United States
Brookmeyer, R., Abdalla, N., Kawas, C. H., & Corrada, M. M. (2018) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2017.10.009 · Cited by 406 · see citing works
Baek, H., Cho, M., Kim, S., Hwang, H. Y., Song, M., & Yoo, S. (2018) · PLoS ONE · doi:10.1371/journal.pone.0195901 · Cited by 346 · see citing works
Time to diagnosis in young-onset dementia as compared with late-onset dementia
van Vliet, D., de Vugt, M. E., Bakker, C., Pijnenburg, Y. A. L., Vernooij-Dassen, M. J. F. J., Koopmans, R. T. C. M., & Verhey, F. R. J. (2013) · Psychological Medicine · doi:10.1017/s0033291712001122 · Cited by 309 · see citing works
Possin, K. L., Merrilees, J. J., Dulaney, S., Bonasera, S. J., Chiong, W., Lee, K., Hooper, S. M., Allen, I. E., Braley, T., Bernstein, A., et al. (2019) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2019.4101 · Cited by 272 · see citing works
Emergency Department Use Among Older Adults With Dementia
LaMantia, M. A., Stump, T. E., Messina, F. C., Miller, D. K., & Callahan, C. M. (2016) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000118 · Cited by 235 · see citing works
Deaths in the United States among persons with Alzheimer's disease (2010–2050)
Weuve, J., Hebert, L. E., Scherr, P. A., & Evans, D. A. (2014) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2014.01.004 · Cited by 173 · see citing works
Parker, M., Barlow, S. H., Hoe, J., & Aitken, L. M. (2020) · International Psychogeriatrics · doi:10.1017/s1041610219002229 · Cited by 157 · see citing works
Validation of Claims Algorithms to Identify Alzheimer’s Disease and Related Dementias
McCarthy, E. P., Chang, C., Tilton, N., Kabeto, M. U., Langa, K. M., & Bynum, J. (2021) · The Journals of Gerontology Series A · doi:10.1093/gerona/glab373 · Cited by 150 · see citing works
Burden of caregivers of patients with Alzheimer's disease
Budzyńska, A., Talarska, D., & Bączyk, G. (2018) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12626 · Cited by 118 · see citing works
Evaluation of Medicare Claims Data as a Tool to Identify Dementia
Lee, E., Gatz, M., Tseng, C.-C., Schneider, L. S., Pawluczyk, S., Wu, A. H., & Deapen, D. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-181005 · Cited by 104 · see citing works
Clevenger, C. K., Chu, T. A., Yang, Z., & Hepburn, K. W. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04108.x · Cited by 94 · see citing works
Triggered palliative care for late-stage dementia: A pilot randomized trial
Hanson, L. C., Kistler, C. E., Lavin, K., Gabriel, S. L., Ernecoff, N. C., Lin, F.-C., Sachs, G. A., & Mitchell, S. L. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2018.10.494 · Cited by 92 · cited 1× · see citing works
“This presents opportunities to develop ED-based palliative care delivery models to discharge PLwD directly from the ED to hospice as well as to address these barriers of direct referral.(32) Our mortality analysis indicates those with AD/ADRD are more likely to die within 12 months of their index ED visit after adjust…”
BackgroundThe Public Health Road Map to Respond to the Growing Dementia Crisis
Olivari, B. S., French, M. E., & McGuire, L. C. (2020) · Innovation in Aging · doi:10.1093/geroni/igz043 · Cited by 84 · see citing works
30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia
Kent, T., Lesser, A., Israni, J., Hwang, U., Carpenter, C., & Ko, K. J. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16114 · Cited by 68 · see citing works
Grudzen, C. R., Brody, A. A., Chung, F. R., Cuthel, A. M., Mann, D., McQuilkin, J. A., Rubin, A. L., Swartz, J. L., Tan, A. J., & Goldfeld, K. S. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-030099 · Cited by 61 · see citing works
Self-citationGeddis‐Regan, A., Errington, L., Abley, C., Wassall, R. R., Exley, C., & Thomson, R. (2020) · Health Expectations · doi:10.1111/hex.13167 · Cited by 61 · see citing works
Hospice Access for Individuals With Dementia
McCarty, C., & Volicer, L. (2009) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317509348207 · Cited by 47 · see citing works
Gillespie, S. M., Wasserman, E. B., Wood, N. E., Wang, H., Dozier, A. M., Nelson, D. L., McConnochie, K. M., & Shah, M. N. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.03.024 · Cited by 46 · see citing works
Impact of Comorbid Dementia on Patterns of Hospice Use
Aldridge, M. D., Hunt, L., Husain, M., Li, L., & Kelley, A. (2022) · Journal of Palliative Medicine · doi:10.1089/jpm.2021.0055 · Cited by 39 · see citing works
Ringer, T. J., Dougherty, M., McQuown, C. M., Melady, D., Ouchi, K., Southerland, L. T., & Hogan, T. M. (2018) · AEM Education and Training · doi:10.1002/aet2.10205 · Cited by 38 · see citing works
Lourida, I., Gwernan‐Jones, R., Abbott, R. A., Rogers, M., Green, C., Ball, S., Hemsley, A. G., Cheeseman, D., Clare, L., Moore, D. A., et al. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01534-7 · Cited by 27 · see citing works
Factors influencing hospital admission among patients with autopsy‐confirmed dementia
Matsuoka, T., Manabe, T., Akatsu, H., Hashizume, Y., Yamamoto, S., Ogawa, N., Kanesaka, T., Taniguchi, C., Yamamoto, T., & Mizukami, K. (2019) · Psychogeriatrics · doi:10.1111/psyg.12393 · Cited by 17 · see citing works
Ding, J., Johnson, C. E., Lee, Y. C. (., Gazey, A., & Cook, A. G. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16458 · Cited by 17 · see citing works
Acute care utilization risk among older adults living undiagnosed or unaware of dementia
Amjad, H., Samus, Q. M., Huang, J., Gundavarpu, S., Bynum, J., Wolff, J. L., & Roth, D. L. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17550 · Cited by 17 · see citing works
Decreasing preventable emergency department transfers for long-term care residents using PREVIEW-ED©
ElBestawi, M. R., & Kohm, C. (2018) · Healthcare Management Forum · doi:10.1177/0840470417753969 · Cited by 13 · see citing works
Safe to send home? Discharge risk assessment in the emergency department
Southerland, L. T., Pearson, S. M., Hullick, C., et al. (2019) · Emergency Medicine Australasia · doi:10.1111/1742-6723.13250 · Cited by 12 · see citing works
Use of Post-Acute Care by Medicare Beneficiaries With a Diagnosis of Dementia
Burke, R. E., Xu, Y., & Ritter, A. Z. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2021.09.016 · Cited by 11 · see citing works
Bercovitz, A., Jamoom, E. W., & Lau, D. T. (2018) · PubMed · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2023 Alzheimer's disease facts and figures
(2023) · Alzheimer's & Dementia · doi:10.1002/alz.13016 · Cited by 3,212 · see citing works
2024 Alzheimer's disease facts and figures
(2024) · Alzheimer's & Dementia · doi:10.1002/alz.13809 · Cited by 2,536 · see citing works
- Authors
- Hill, J. D., Schmucker, A. M., Siman, N., Goldfeld, K. S., Cuthel, A. M., Chodosh, J., Bouillon‐Minois, J., & Grudzen, C. R.
- Affiliations
- New York University (US)
- University of Pennsylvania (US)
- NYU Langone Health (US)
- Centre Hospitalier Universitaire de Clermont-Ferrand (FR)
- Corresponding author
- Cuthel, Allison M.
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2022-05-25
- Volume
- 70
- Issue
- 9
- Pages
- 2582-2591
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC9489611
- OpenAlex
- W4281476995
- Cited by
- 28
- References
- 33
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 2
- FWCI
- 5.80
- 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 (UG3/UH3 AT009844)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- Alzheimer's disease, Alzheimer's disease and related dementias, dementia, emergency department visits, emergency department disposition, hospital readmission, health care utilization, mortality, older adults, post-discharge care, hospice
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Chronic Disease, Emergency Medical Services, Female, Medicare, Hospitalization, Humans, United States, Hospice Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
