Incidence of New Dementia Diagnosis in Veterans Admitted to Nursing Homes After Heart Failure Hospitalization.
Alzheimer’s disease
cognition
dementia diagnosis
heart failure
multimorbidity
multiple chronic conditions
neurocognitive disorders
nursing homes
veterans
Journal
Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863
Informations de publication
Date de publication:
2023
2023
Historique:
medline:
22
8
2023
pubmed:
10
7
2023
entrez:
10
7
2023
Statut:
ppublish
Résumé
Hospitalization with heart failure (HF) may signal an increased risk of Alzheimer's disease and related dementias (ADRD). Nursing homes routinely assess cognition but the association of these results with new ADRD diagnosis in a population at high risk of ADRD is not known. To determine the association between nursing home cognitive assessment results and new diagnosis of dementia after heart failure hospitalization. This retrospective cohort study included Veterans hospitalized for HF and discharged to nursing homes, from 2010 to 2015, without a prior diagnosis of ADRD. We determined mild, moderate, or severe cognitive impairment using multiple items of the nursing home admission assessment. We used Cox regression to determine the association of cognitive impairment with new ADRD diagnosis during 365 days of follow-up. The cohort included 7,472 residents, new diagnosis of ADRD occurred in 4,182 (56%). The adjusted hazard ratio of ADRD diagnosis was 4.5 (95% CI 4.2, 4.8) for the mild impairment group, 5.4 (95% CI 4.8, 5.9) for moderate impairment, and 4.0 (95% CI 3.2, 5.0) for severe impairment compared to the cognitively intact group. New ADRD diagnoses occurred in more than half of Veterans with HF admitted to nursing homes for post-acute care.
Sections du résumé
BACKGROUND
Hospitalization with heart failure (HF) may signal an increased risk of Alzheimer's disease and related dementias (ADRD). Nursing homes routinely assess cognition but the association of these results with new ADRD diagnosis in a population at high risk of ADRD is not known.
OBJECTIVE
To determine the association between nursing home cognitive assessment results and new diagnosis of dementia after heart failure hospitalization.
METHODS
This retrospective cohort study included Veterans hospitalized for HF and discharged to nursing homes, from 2010 to 2015, without a prior diagnosis of ADRD. We determined mild, moderate, or severe cognitive impairment using multiple items of the nursing home admission assessment. We used Cox regression to determine the association of cognitive impairment with new ADRD diagnosis during 365 days of follow-up.
RESULTS
The cohort included 7,472 residents, new diagnosis of ADRD occurred in 4,182 (56%). The adjusted hazard ratio of ADRD diagnosis was 4.5 (95% CI 4.2, 4.8) for the mild impairment group, 5.4 (95% CI 4.8, 5.9) for moderate impairment, and 4.0 (95% CI 3.2, 5.0) for severe impairment compared to the cognitively intact group.
CONCLUSION
New ADRD diagnoses occurred in more than half of Veterans with HF admitted to nursing homes for post-acute care.
Identifiants
pubmed: 37424463
pii: JAD221300
doi: 10.3233/JAD-221300
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1397-1404Subventions
Organisme : NIA NIH HHS
ID : R01 AG065722
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG077620
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG079295
Pays : United States