|Title||Incidence of potentially disruptive medical and social events in older adults with and without dementia.|
|Publication Type||Journal Article|
|Year of Publication||2022|
|Authors||Hunt, LJ, R Morrison, S, Gan, S, Espejo, E, Ornstein, KA, W Boscardin, J, Smith, AK|
|Journal||Journal of the American Geriatrics Society|
|Keywords||Dementia, Hip fracture, Pneumonia, Widowhood|
BACKGROUND: Potentially disruptive medical, surgical, and social events-such as pneumonia, hip fracture, and widowhood-may accelerate the trajectory of decline and impact caregiving needs in older adults, especially among people with dementia (PWD). Prior research has focused primarily on nursing home residents with dementia. We sought to assess the incidence of potentially disruptive events in community-dwelling people with and without dementia.
METHODS: Retrospective cohort study of participants aged 65+ enrolled in the Health and Retirement Study between 2010 and 2018 (n = 9346), including a subset who were married-partnered at baseline (n = 5105). Dementia was defined with a previously validated algorithm. We calculated age-adjusted and gender-stratified incidence per 1000 person-years and incidence rate ratios of: 1) hospitalization for pneumonia, 2) hip fracture, and 3) widowhood in people with and without dementia.
RESULTS: PWD (n = 596) were older (mean age 84 vs. 75) and a higher proportion were female (67% vs. 57%) than people without dementia (PWoD) (n = 8750). Age-adjusted incidence rates (per 1000 person-years) of pneumonia were higher in PWD (113.1; 95% CI 94.3, 131.9) compared to PWoD (62.1; 95% CI 54.7, 69.5), as were hip fractures (12.3; 95% CI 9.1, 15.6 for PWD compared to 8.1; 95% CI 6.9, 9.2 in PWoD). Point estimates of widowhood incidence were slightly higher for PWD (25.3; 95% CI 20.1, 30.5) compared to PWoD (21.9; 95% CI 20.3, 23.5), but differences were not statistically significant. The association of dementia with hip fracture-but not pneumonia or widowhood-was modified by gender (male incidence rate ratio [IRR] 2.24, 95% CI 1.34, 3.75 versus female IRR 1.31 95% CI 0.92,1.86); interaction term p = 0.02).
CONCLUSIONS: Compared to PWoD, community-dwelling PWD had higher rates of pneumonia and hip fracture, but not widowhood. Knowing how often PWD experience these events can aid in anticipatory guidance and care planning for this growing population.
|PubMed Central ID||PMC9106866|
|Grant List||P01AG066605 / AG / NIA NIH HHS / United States |
P01 AG066605 / AG / NIA NIH HHS / United States
P30AG028741 / AG / NIA NIH HHS / United States
R33AG065726 / AG / NIA NIH HHS / United States
KL2TR001870 / TR / NCATS NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States
/ / National Palliative Care Research Center /
K24AG068312 / AG / NIA NIH HHS / United States