ICU admissions are increasing for Alzheimer’s and Dementia patients, and so are post-discharge mortality rates
MDlinx Jul 18, 2023
In a new study on life expectancy and intensive care unit (ICU) visits, researchers found that patients with Alzheimer’s disease and related dementia (ADRD) were twice as likely to die shortly after discharge than patients without an ADRD diagnosis. The researchers suggest that their findings may have implications for developing new post-ICU strategies for increasing ADRD patients’ chances of survival.
“Patients with ADRD often have a limited life expectancy, which can be further shortened after an ICU admission or other acute event,” Mary Lynn Davis-Ajami, PhD, FNP, RN, co-author of the study and a health services researcher, said in a press release. “Our findings raise questions about proactive strategies to diminish the likelihood of an ICU admission or early discussions with families and caregivers about palliative care.”
Patients with alzheimer disease, dementia face 2x risk of dying after icu discharge.
The observational study looked at data from Optum’s Clinformatics Data Mart Database and included patients older than 67 with continuous Medicare Advantage coverage from 2016 to 2019. Researchers used the data to compare post-ICU outcomes—including if the patient was discharged to a home or other facility or if the patient died within the same month or within one year of discharge—between ADRD patients and patients without ADRD. Patients were identified as either having or not having ADRD based on claims data. About one-third of ADRD patients in the study went home after ICU care, compared to about two-thirds of those without ADRD.
Establishing better care could be crucial for ADRD patients, the numbers of which continue to grow. Today, an estimated 6.5 million Americans age 65 and older adults live with ADRD, according to 2022 data. This number is projected to rise in the coming years and, by 2060, could grow to 13.8 million.
2022 Alzheimer's disease facts and figures. Alzheimers Dement. 2022 Apr;18(4):700-789. doi: 10.1002/alz.12638. Epub 2022 Mar 14. PMID: 35289055.
2022 Alzheimer’s disease facts and figures. Alzheimers Dement. 2022;18(4):700-789.
Furthermore, older adults with ADRD are already more likely to end up in the ICU than older adults without ADRD, according to the study’s researchers.
They add that the recent findings provide new insight into how the disease impacts patients on Medicare Advantage (MA) plans specifically, and that the study may be the first published to examine the intersection between the two. Being dually eligible for Medicare and Medicaid increases a person's risk of not being discharged from an ICU stay or dying within the same month as discharge and within 12 months after discharge, according to the study.
Patients with alzheimer disease, dementia face 2x risk of dying after icu discharge.
Now, the findings may fill a timely research gap, as the government changed how MA beneficiaries can access hospice care in 2023.
What this means for you
After being discharged from an intensive care unit, older adults with Alzheimer’s and related dementia (ADRD) were twice as likely to die than those without, according to a new study. The researchers suggest that their findings can give insight into where to focus care approaches and care coordinating after patients with ADRD are discharged from the ICUs.
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