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Prediction of general hospital admission in people with dementia: cohort study
Tom C Russ1, Mario A Parra1, Alison E Lim1
1Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
Background:
People with dementia are extremely vulnerable in hospital and unscheduled admissions should be avoided if possible.
Aims:
To identify any predictors of general hospital admission in people with dementia in a well-characterised national prospective cohort study.
Method:
A cohort of 730 persons with dementia was drawn from the Scottish Dementia Research Interest Register (47.8% female; mean age 76.3 years, s.d. = 8.2, range 50-94), with a mean follow-up period of 1.2 years.
Results:
In the age- and gender-adjusted multivariable model (n = 681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per s.d. disadvantage 1.21, 95% CI 1.08-1.36) was identified as an independent predictor of admission to hospital.
Conclusions:
Neuropsychiatric symptoms in dementia, measured using the Neuropsychiatric Inventory, predict non-psychiatric hospital admission of people with dementia. Further studies are merited to test whether interventions to reduce such symptoms might reduce unscheduled admissions to acute hospitals.
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