February 21st 2018
Elderly people with dementia are about 1.5 times more likely to be readmitted to the hospital soon after being discharged than non-sufferers with the same diseases or injuries, a Japanese research team has announced.
The team, which includes members of the Institute for Health Economics and Policy (IHEP) and the National Cancer Center, conducted the nation’s first study to analyze the data of about 1.8 million patients. Its research paper was carried Tuesday in the American Geriatrics Society (AGS)’s online magazine.
The study showed a number of patients were readmitted due to such problems as breaking a hip joint, a brain infarction or pneumonia, apparently the result of factors including physical depression triggered by hospitalization and difficulty in taking drugs after leaving the hospital.
IHEP senior researcher Nobuo Sakata and his team used the data of 1.83 million patients aged 65 or older who were admitted to 987 hospitals nationwide between April 2014 and September 2015.
Researchers judged whether each person had dementia based on the degree of their independence in daily activities and types of drugs they were taking, and learned that 270,000 patients had dementia and 1.56 million did not. The team then compared the readmission of patients with dementia within 30 days from discharge with that of patients without dementia.
A total of 86,000 people were readmitted. The risk of people with dementia being readmitted after returning home or to nursing care facilities was 1.46 times that of people without dementia, after the age imbalance was adjusted.
By diseases and injuries, patients with dementia suffer hip fractures in a fall at a rate of 1.46 times that of people without, followed by 1.3 times the level of brain infarctions and 1.23 times the rate of aspiration pneumonia. This trend was the same regardless of the seriousness of the dementia.
People with dementia generally tend to suffer disturbances of consciousness or agitation after admission, due to the environmental change and medication, according to the team. They are often confined to their bed or are physically restrained for safety, and such actions reduce the amount of activities they can do, likely resulting in a decline in their physical and cognitive functions.
It is said that people with dementia are discharged from the hospital without receiving balanced treatment devised with consideration for their condition, and tend to readily suffer diseases or injuries again, according to the researchers.
To prevent patients’ physical functions from deteriorating during hospitalization, the team said it was important to alleviate their pain and give nutritional care. Regarding proper methods of medication, as well as eating and drinking after being discharged from a hospital, the team suggested hospitals provide advice and make follow-up telephone calls to the patient’s family and care staff.
“The fact that elderly people with dementia become extremely weak has not been shared between the medical and nursing fronts and patient’s families,” said Asao Ogawa, chief of National Cancer Center Hospital East’s Psycho-oncology department. “It’s urgent to build a more lifestyle-focused support system.”