Descriptive analysis of hospitalizations of patients with Alzheimer's disease: a two-year prospective study of 686 patients from the REAL.FR study.

OBJECTIVES: There is lack of data on the frequency and the causes of hospitalization in mild to moderate Alzheimer's disease (AD) patients. The aims of the present study were to evaluate the frequency and the causes of hospitalization in a large prospective cohort of mild to moderate patients with AD.
DESIGN: Six hundred and eighty-six AD patients from the French Network on AD (REAL.FR) were followed up and assessed every 6 months for 2 years. During follow-up, all events occurring between two visits, in particular hospital admissions or nursing home placements were carefully recorded.
RESULTS: Annual incidences for hospitalizations were 26.2% (95% CI, 22.5 to 29.7). After two years, 202 subjects were hospitalized for 296 hospitalizations. 139 subjects were hospitalized once, 40 twice, 13 three times, 4 four times and 2 five times during the two-year follow-up. The duration of hospitalization was 14.3 +/- 23.5 days. For repeated hospitalizations, the time interval between the first and the second hospitalization was 176.4 days (SD 150.2) and the cause of multiple hospitalizations was most different. Fractures and falls not causing fracture were the main reasons for hospital admission (20.9%), followed by cardiovascular disorders (14.5%) and by behavioural disorders (11.0%). Admission due to associated diseases or life events was the main reason for hospitalization (75.7%).
CONCLUSIONS: Hospitalization is a frequent event for AD patients even at mild to moderate stage of the disease. In this cohort, the major causes for hospital admission were due to associated diseases or life events and not due to the direct consequences of the disease itself.