Hospitalization rates and predictors in people with dementia: A systematic review and meta-analysis
BMC Medicine Jul 19, 2019
Shepherd H, et al. - Observational studies which investigated community-dwelling individuals with dementia of any age or dementia sub-type, diagnosed dementia using validated diagnostic criteria, and assessed all-cause general (ie, non-psychiatric) hospital admissions were included by researchers to assess hospitalization rates of patients with dementia and if these differed from individuals without dementia. They also wanted to recognize socio-demographic and clinical predictors of hospitalization. Thirty-four studies (17 from the US, 15 from Europe, and 2 from Asia) with 277,432 patients with dementia were involved. In comparison to those without dementia, the pooled relative risk of hospitalization for those with dementia was 1.42 in studies adjusted for age, sex, and physical comorbidity. In high-quality studies, hospitalization rates in cases with dementia were between 0.37 and 1.26/person-year. Robust evidence indicated that admission correlated with older age, and moderately powerful evidence indicated that multimorbidity, polypharmacy, and lower functional ability were related to admission were found. Dementia subjects were more commonly admitted to hospital compared to those without dementia, independent of physical comorbidities. Furthermore, to decrease unnecessary hospitalizations, interventions should focus on modifiable factors, such as polypharmacy and functional ability, in high-risk populations.
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