Care needs and clinical outcomes of older people with dementia: a population-based propensity score-matched cohort study - PubMed (original) (raw)

Care needs and clinical outcomes of older people with dementia: a population-based propensity score-matched cohort study

Fei-Yuan Hsiao et al. PLoS One. 2015.

Abstract

Objective: To explore the healthcare resource utilization, psychotropic drug use and mortality of older people with dementia.

Design: A nationwide propensity score-matched cohort study.

Setting: National Health Insurance Research database.

Participants: A total of 32,649 elderly people with dementia and their propensity-score matched controls (n=32,649).

Measurements: Outpatient visits, inpatient care, psychotropic drug use, in-hospital mortality and all-cause mortality at 90 and 365 days.

Results: Compared to the non-dementia group, a higher proportion of patients with dementia used inpatient services (1 year after index date: 20.91% vs. 9.55%), and the dementia group had more outpatient visits (median [standard deviation]: 7.00 [8.87] vs. 3.00 [8.30]). Furthermore, dementia cases with acute admission had the highest psychotropic drug utilization both at baseline and at the post-index dates (difference-in-differences: all <0.001). Dementia was associated with an increased risk of all-cause mortality (90 days, Odds ratio (OR)=1.85 [95%CI 1.67-2.05], p<0.001; 365 days, OR=1.59 [1.50-1.69], p<0.001) and in-hospital mortality (90 days, OR=1.97 [1.71-2.27], p<0.001; 365 days, OR=1.82 [1.61-2.05], p<0.001) compared to matched controls.

Conclusions: When older people with dementia are admitted for acute illnesses, they may increase their use of psychotropic agents and their risk of death, particularly in-hospital mortality.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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FYH received a part-time research assistantship from a research grant (NSC102-2410-H-002-058-MY2), which was sponsored by the National Science Council, Taiwan, and a research grant sponsored by the Food and Drug Administration, Taiwan (DOH102-FDA-41100).

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