Adults With Dementia Visit EDs More Often Than Adults Without

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Older adults with dementia visit emergency departments (EDs) more frequently than older adults without dementia and also return at higher rates and incur greater costs, according to research from the Regenstrief Institute and the Indiana University Center for Aging Research.

The study is one of the first to explore healthcare use patterns and mortality rates in those with cognitive impairment.

The researchers analyzed data for 32 697 adults aged 65 and older with and without dementia who visited the ED over an 11-year period at Eskenazi Health in central Indiana. They found that those with dementia were more likely to be admitted to the hospital and had a higher death rate following an ED visit compared with those without dementia.

Between one-third and one-half of the adults with dementia visited the ED in any given year. Five years after visiting the ED, only 46% of those with dementia were alive compared with 76% of adults without dementia.

The researchers also noted that 53% of those with dementia who visited the ED were discharged rather than being admitted to the hospital. This raises the question of whether the visit was medically necessary, whether the patients received care in a lower cost setting, or whether the decisions to discharge them were flawed.

“As people live longer we will increasingly be faced with a growing number of individuals with cognitive impairment. We now know that survival rates after an ED visit differ significantly by cognitive status,” said Michael LaMantia, MD, MPH, assistant professor of medicine at IU School of Medicine. “We need to continue to learn how to provide better care to these vulnerable individuals in fast-paced emergency departments and after their visits to the ED.”

Adults With Dementia Visit EDs More Often Than Adults Without
Adults with dementia were more likely to be admitted to the hospital and had a higher death rate after an ED visit.

Older adults with dementia are more frequent visitors to emergency departments, returning at higher rates and incurring greater costs than older adults without dementia, according to a new study from the Regenstrief Institute and the Indiana University Center for Aging Research. The study is one of the first to explore long-term patterns of healthcare use and mortality rates of elders with cognitive impairment who visit the emergency department.

Older adults with dementia are also more likely to be admitted to the hospital (not a trivial event for this age group) and have a higher death rate following an emergency department visit than those without dementia, according to the study of 32 697 individuals aged 65 and older with and without dementia who sought emergency care over an 11-year period at Eskenazi Health, a large, urban, safety-net healthcare system.

Between one-third and half of older adults with dementia made an emergency department visit in any given year. Five years after their first emergency department visit, only 46% of those with dementia were alive while 76% of older adults without dementia who visited an emergency department had survived.

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