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La asociación de demencia incidente con las hospitalizaciones
Elizabeth A Phelan1, Soo Borson, Louis Grothaus
1Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98104-2499, USA. phelane@uw.edu
JAMA
|January 12, 2012
Resumen
Los nuevos diagnósticos de demencia aumentan significativamente los riesgos de hospitalización, especialmente para afecciones prevenibles. Esto destaca la necesidad de una mejor atención ambulatoria para reducir los ingresos hospitalarios en adultos mayores con demencia.
Área de la Ciencia:
- Gerontología Gerontología.
- Neurología Neurología.
- Salud Pública La salud pública.
Sus antecedentes:
- La demencia está relacionada con mayores tasas de hospitalización y peores resultados.
- Existe la necesidad de identificar las admisiones hospitalarias potencialmente prevenibles para las personas con demencia.
Objetivo del estudio:
- Para investigar la asociación entre el inicio de la demencia y las tasas de hospitalización.
- Examinar si la demencia está relacionada con diferentes razones para la hospitalización, en particular las afecciones sensibles a la atención ambulatoria (ACSC).
Principales métodos:
- Análisis retrospectivo de hospitalizaciones en 3019 adultos mayores de 65 años del estudio Adult Changes in Thought (ACT).
- Los datos de 1994-2007 se utilizaron para comparar las tasas de ingreso hospitalario de las personas que desarrollaron demencia frente a las que permanecieron libres de demencia.
- El análisis se centró en las admisiones por todas las causas y las admisiones para los ACSC.
Principales resultados:
- Las personas que desarrollaron demencia tuvieron tasas de admisión por todas las causas significativamente más altas (proporción ajustada de 1.41) en comparación con las que permanecieron libres de demencia.
- Las tasas de hospitalización por afecciones sensibles a la atención ambulatoria (ACSC) también fueron significativamente más altas en el grupo de demencia (proporción ajustada de 1,78).
- Los ACSC específicos con mayores tasas de admisión en el grupo de demencia incluyeron neumonía, insuficiencia cardíaca, deshidratación, úlceras e infecciones del tracto urinario.
Conclusiones:
- La incidencia de demencia está significativamente asociada con un mayor riesgo de hospitalización en adultos mayores.
- Este mayor riesgo se extiende a las hospitalizaciones por afecciones sensibles a la atención ambulatoria, lo que sugiere un potencial para la prevención.
- Los hallazgos subrayan la importancia de la gestión proactiva de pacientes ambulatorios para las personas en riesgo de o diagnosticadas con demencia.
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