Literature DB >> 22264688

Improving care of older adults with dementia: description of 6299 hospitalizations over 11 years in a special acute care unit.

Maria E Soto1, Sandrine Andrieu, Hélène Villars, Marion Secher, Virginie Gardette, Nicola Coley, Fati Nourhashemi, Bruno Vellas.   

Abstract

OBJECTIVE: To describe hospitalizations in a Special Acute Care inpatient Unit for older adults with Alzheimer's disease (AD) and other related disorders.
DESIGN: An 11-year observational study of consecutive hospitalizations from 1996 to 2006.
SETTING: The Alzheimer Special Acute Care inpatient Unit in the Geriatrics Department of the Toulouse University Hospital, France. PARTICIPANTS: A total of 4708 patients with dementia accounting for 6299 consecutive hospitalizations. MEASUREMENTS: Data regarding admission causes, cognition, physical disability, nutritional assessment, behavioral and psychological symptoms of dementia, and sociodemographics were recorded.
RESULTS: Data from 6299 hospitalizations are presented: 4708 (74.7%) hospitalizations accounted for first-time admissions and 1591 (25.3%) were rehospitalizations. Among the first-time admissions, complications of dementia and cognitive diagnosis experienced a significant switch in frequency. Whereas until 2001, the main cause of admission was for a diagnosis (51%), complications became the primary cause from 2003 onward with a significant increasing trend (56%) (P < .001). The most frequent cause of complications was behavioral and psychological symptoms of dementia, with a significant trend for an increased frequency (P < .001). Agitation-aggressiveness represented 60% of behavioral and psychological symptoms of dementia. Between 1996 and 2006, the age of patients at first-time admission gradually increased over time, as did the severity of cognitive impairment and the prevalence of unsatisfactory nutritional status (P for trend < .001 for each variable).
CONCLUSIONS: The evolving patient characteristics and the causes of first-time admissions changed over the course of 11 years. Behavioral and psychological symptoms of dementia, especially agitation-aggressiveness, have progressively become the key drivers of Special Acute Care inpatient Unit hospitalizations. These findings suggest that the role, mission, and functioning of the Special Acute Care inpatient Unit within the Alzheimer care system has been modified over time.
Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 22264688     DOI: 10.1016/j.jamda.2011.12.058

Source DB:  PubMed          Journal:  J Am Med Dir Assoc        ISSN: 1525-8610            Impact factor:   4.669


  11 in total

Review 1.  [Hospitalization and dementia: what was new in 2012?: literature review].

Authors:  W Hofmann
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2.  [Special care units for acutely ill patients with cognitive impairment in Germany. Position paper].

Authors:  W Hofmann; A Rösler; W Vogel; H G Nehen
Journal:  Z Gerontol Geriatr       Date:  2014-02       Impact factor: 1.281

3.  [Special care units for patients with cognitive impairment : Results of a nationwide survey in geriatric hospitals in Germany].

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Journal:  Z Gerontol Geriatr       Date:  2018-09-03       Impact factor: 1.281

Review 4.  Anticholinergic burden for prediction of cognitive decline or neuropsychiatric symptoms in older adults with mild cognitive impairment or dementia.

Authors:  Martin Taylor-Rowan; Olga Kraia; Christina Kolliopoulou; Anna H Noel-Storr; Ahmed A Alharthi; Amanda J Cross; Carrie Stewart; Phyo K Myint; Jenny McCleery; Terry J Quinn
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5.  Medication development for agitation and aggression in Alzheimer disease: review and discussion of recent randomized clinical trial design.

Authors:  Maria Soto; Sandrine Andrieu; Fati Nourhashemi; Pierre Jean Ousset; Clive Ballard; Philippe Robert; Bruno Vellas; Constantine G Lyketsos; Paul B Rosenberg
Journal:  Int Psychogeriatr       Date:  2014-09-16       Impact factor: 3.878

6.  Multimorbidity type, hospitalizations and emergency department visits among nursing home residents: a preliminary study.

Authors:  P de Souto Barreto; M Lapeyre-Mestre; B Vellas; Y Rolland
Journal:  J Nutr Health Aging       Date:  2014-07       Impact factor: 4.075

Review 7.  Hospital outcomes of older people with cognitive impairment: An integrative review.

Authors:  Carole Fogg; Peter Griffiths; Paul Meredith; Jackie Bridges
Journal:  Int J Geriatr Psychiatry       Date:  2018-06-26       Impact factor: 3.485

8.  Development and validation of clinical profiles of patients hospitalized due to behavioral and psychological symptoms of dementia.

Authors:  Claudia Ortoleva Bucher; Nicole Dubuc; Armin von Gunten; Lise Trottier; Diane Morin
Journal:  BMC Psychiatry       Date:  2016-07-22       Impact factor: 3.630

9.  Telemedicine for the management of neuropsychiatric symptoms in long-term care facilities: the DETECT study, methods of a cluster randomised controlled trial to assess feasibility.

Authors:  Antoine Piau; Fati Nourhashemi; Adélaïde De Mauléon; Achille Tchalla; Claude Vautier; Bruno Vellas; Maryline Duboue; Nadège Costa; Pierre Rumeau; Benoit Lepage; Maria Soto Martin
Journal:  BMJ Open       Date:  2018-06-12       Impact factor: 2.692

10.  Health workers perception on telemedicine in management of neuropsychiatric symptoms in long-term care facilities: Two years follow-up.

Authors:  Antoine Piau; Claude Vautier; Adelaïde De Mauleon; Achille Tchalla; Pierre Rumeau; Fati Nourhashemi; Maria Soto-Martin
Journal:  Geriatr Nurs       Date:  2020-08-06       Impact factor: 2.361

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