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P2‐433: 30‐Day Hospital Readmissions Among Medicare Beneficiaries With Alzheimer’s Disease and Related Dementias Prior to and Following Diagnosis
Author(s) -
Lin Pei-Jung,
Zhong Yue,
Fillit Howard M.,
Chen Er,
Neumann Peter J.
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.1645
Subject(s) - medicine , dementia , disease , hospital readmission , emergency medicine , pneumonia , acute care , stroke (engine) , health care , mechanical engineering , engineering , economics , economic growth
tia (YOD) is predominantly caused by autosomal-dominant factors, though these account for less than 20% of cases. The aim of this study is to gather detailed data regarding exposure to potentially modifiable environmental and lifestyle risk factors, and assess associated risk for primary degenerative and vascular YOD. Methods: Participants with YOD were recruited via relevant health care professionals or were self-referred, and their dementia diagnosis was confirmed by clinical consensus. Pair-matched control participants were recruited via GP clinics and matched by geographical location, sex and five-year age group. Exposure data were collected using surveys and structured interviews with the participant and/or an informant. Family history of dementia was entered as a covariate. Results: To date, 122 control participants and 77 people with YOD were included. Case aetiology included Alzheimer’s disease (n1⁄450), frontotemporal dementia (n 1⁄414), vascular/mixed dementia (n1⁄49), Lewy Body disease (n1⁄42) and unspecified degenerative dementia (n1⁄42). Risk for YOD was significantly associated with stroke (OR1⁄47.47, 95% CI:2.4-23.4), low education (OR1⁄44.8, 95% CI:2.1-11.0), smoking (OR1⁄42.23, 95%CI:1.3-4.1), and early or midlife depression (OR1⁄42.04, 95% CI:1.2-3.8). Analyses were repeated for AD alone, and all effects aside from depression (OR1⁄41.7, 95% CI:0.9-3.3) were attenuated but retained significance. Risk for YOD was not associated with cardiovascular risk factors commonly reported in studies of older people, such as hypertension, hypercholesterolemia and type II diabetes (all ns). Conclusions: Potentially modifiable environmental and lifestyle risk factors such as low education and smoking as well as clinical conditions such as depression and stroke are associated with increased risk for YOD. The effect of cardiovascular risk factors in YODwarrants further investigation. It is possible that they are not relevant to YOD, or require more years of cumulative exposure to confer risk.