Does Having Alzheimer’s Disease and Dementia Affect Severity of Delirium?

Journal of the American Geriatrics Society Research Summary

Forms of dementia, including Alzheimer’s disease, gradually affect your cognitive function by harming your memory and your ability to think and make decisions. By 2050, experts project that 13.8 million older adults in the United States will develop Alzheimer’s disease and related Dementias (ADRD). Although Alzheimer’s disease is the most common form of dementia, other forms include Lewy Body dementia, frontotemporal dementia, and vascular dementia—all of which have upsetting consequences for people with dementia and their families.

Since no cure or treatment yet exists for ADRD, healthcare providers currently focus on preventing the treatable risk factors that can lead to dementia. This strategy could potentially slow the onset and progression of ADRD.

Hospitalization poses risks to people with ADRD and can have life-threatening consequences, including predisposing us to delirium (the medical term for a rapid change in mental state, often marked by confusion), a decline in mental or physical function, being admitted to long-term care facilities, and even death.

In particular, delirium can worsen the course of an illness, quicken physical and mental decline, lengthen hospital stays, and cause higher rates of hospital re-admission and death. One in 8 hospitalized people with ADRD who develops delirium will have at least one serious problem, including cognitive decline, possibly leading to admission to long-term care or death.

Here’s the good news: Experts say 30 to 40 percent of delirium cases are preventable. But until now, we have not studied how delirium and its severity affect hospitalized older adults with and without ADRD. Continue reading

After a Hospitalization, Older Adults Prescribed Potentially Inappropriate Medications May Face Health Risks

Journal of the American Geriatrics Society Research Summary

Potentially inappropriate medications (PIMs)” are treatments that sometimes pose risks that outweigh their benefits, particularly for people who are 65 or older. About 20 to 60 percent of older adults take medicines that may be potentially inappropriate. That can increase the risk for being hospitalized, needing to visit the emergency department, having poor quality of life, and/or experiencing a harmful reaction.

When older adults are hospitalized for medical reasons or for surgery, they often go home with prescriptions for treatments that may be different from those they were taking beforehand. These treatments may include PIMs. Until now, however, few studies have examined how PIMs affect older adults when prescribed at the time of their hospital discharge.

A team of researchers recently designed a study to learn more about this important issue. They examined information from medical and surgical patients to evaluate the association of PIMs (both the ones the patients had been taking earlier as well as those newly prescribed at their hospital discharge) with the risk of four outcomes. The outcomes were harmful drug problems, emergency department visits, readmission to the hospital, and death after hospital discharge. The study was published in the Journal of the American Geriatrics Society. Continue reading

Many Older Adults Face New Disabilities After Hospital Stays for Serious Illnesses

Journal of the American Geriatrics Society Research Summary

Older adults often face new disabilities after a hospital stay for a serious illness. Among the problems they may need to adjust to are difficulties with bathing and dressing, shopping and preparing meals, and getting around inside and outside the home. These new disabilities can lead to being hospitalized again, being placed in a nursing home, and more permanent declines in well-being. The longer a serious disability lasts, the worse it can be for an older adult.

To learn more about this issue, a research team studied information about a particular group of people. They looked at individuals who were hospitalized for a medical issue but did not require critical care. The study was based on data from the Precipitating Events Project (PEP), an ongoing study of 754 people, aged 70 or older, who lived at home at the beginning of the study. At that time, the participants were not disabled and did not need assistance in four basic activities: bathing, dressing, walking inside the house, and getting out of a chair. The researchers published their study in the Journal of the American Geriatrics Society. Continue reading

Care at Home Lessens Risk of Hospital Re-Admission within 30 Days Following Hospitalization for Heart Failure

Journal of the American Geriatrics Society Research Summary

Older adults who are recovering from heart failure often leave the hospital to stay at rehabilitation facilities (also called skilled nursing facilities) before they return home. However, healthcare practitioners know that the stress of the transitioning from hospital to skilled nursing facility and back to a person’s home can result in an older adult’s readmission to the hospital within 30 days after their discharge.

For that reason, older adults who have heart failure may do better when they get home health care once they return home after their discharges from the hospital and skilled nursing facility.

To learn more, a team of researchers studied the association between hospital readmission risk and receiving home health care after leaving skilled nursing facilities. To do so, they examined the records of Medicare patients, aged 65 and older, who had returned home from skilled nursing facilities following hospitalization for heart failure. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Dementia Increases the Risk of 30-Day Readmission to the Hospital After Discharge

Journal of the American Geriatrics Society Research Summary

About 25 percent of older adults admitted to hospitals have dementia and are at increased risk for serious problems like in-hospital falls and delirium (the medical term for an abrupt, rapid change in mental function). As a result, older adults with dementia are more likely to do poorly during hospital stays compared to older adults without dementia.

Until now, little was known about the effects of dementia on early hospital readmission. Researchers in Japan recently published the results of a study to learn more about the effects of dementia and being admitted to the hospital within 30 days of a previous hospital discharge (the medical term for leaving the hospital once your care is considered complete). Their study was published in the Journal of the American Geriatrics Society.

The researchers studied information from people 65-years-old and older who had been discharged from hospitals between 2014 and 2015, and then followed them for six months. The researchers were looking for unplanned readmissions to the hospital within 30 days of the patient’s discharge. Continue reading