How dementia drives ER visits, admissions and mortality rates

Elderly adults with dementia are more likely to visit the emergency department, be admitted to the hospital and die following a visit, according to a study from the Regenstrief Institute and the Indiana University Center for Aging Research.

Between one-third and half of older adults with dementia visit an ED in any given year, the researchers found after studying nearly 33,000 people who sought emergency care over 11 years at Eskenazi Health, an Indianapolis-based safety-net hospital. Those with dementia returned to the ED more frequently than those without dementia, and their treatment cost more, according to the article.

"We now know that survival rates after an ED visit differ significantly by cognitive status," Michael LaMantia, M.D., assistant professor of medicine at IU School of Medicine, said in the study announcement. "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."

The study found that 53 percent of older dementia patients were discharged rather than admitted. Researchers questioned whether the visits were medically necessary, or whether the discharge decisions were made in error because complications were missed or the patients and their home circumstances weren't fully assessed, according to the article.

One in 10 seniors are victims of emotional, sexual or financial abuse, FierceHealthcare previously reported; dementia complicates the problem.

The Indiana study also found that older adults with dementia are more expensive to treat, a finding echoed by a separate study that the most expensive condition to treat in the last five years of life is dementia. Costs for treating dementia averaged about $287,000, compared with $175,100 for heart disease and $173,400 for cancer.

To learn more:
- read the study announcement

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