Thursday, July 27, 2023

Dementia Results in Nearly 1.4 Million Emergency Visits Annually, Study Finds

Patients with Alzheimer’s disease and related dementias (ADRD) account for nearly 7% of all annual emergency department visits by individuals age 65 and older, according to a report published this week in JAMA Neurology.

“Emergency departments are often not the right place to manage these behaviors,” Lauren Gerlach, D.O., M.S., of the University of Michigan Medical School, said in a news release. “We really need to do better to support caregivers so there are options other than seeking emergency care.”

Gerlach and colleagues analyzed data on emergency department visits by adults aged 65 and older from the 2016-2019 National Hospital Ambulatory Medical Care Survey. The survey collects data from random samples of emergency department visits and includes information on patients’ dementia diagnoses. The primary reason for the visit was reported by the patient or a proxy.

Among more than 20.3 million annual visits to emergency departments by patients aged 65 and older, almost 1.4 million were by patients with Alzheimer’s or a related dementia. Additional findings include the following:

  • Emergency department visits by patients with ADRD were more common among those who were 85 years or older, were female, and/or had medical comorbidities.
  • The most common reasons for the visits by patients with ADRD included accidents (7.9%) and behavioral disturbances (7.4%), which were about twice as likely among this patient population than patients without ADRD.
  • Common diagnoses included dementia with or without behavioral disturbances, symptoms involving cognitive function and awareness, and urinary tract infections.
  • Patients with ADRD were more likely to undergo head computed tomography scans and/or urinalysis compared with patients without ADRD.
  • Patients with ADRD were more likely to receive antipsychotics and less likely to receive opioids.

“Given the high rates of [emergency department] visits for behavioral disturbances, it is perhaps unsurprising that those with ADRD visits were twice as likely to receive antipsychotic agents,” the authors wrote. “Such use is concerning given the increased mortality risk associated with antipsychotic agents and potential for transition to long-term use.”

For related information, see the Psychiatric News Alert “Dementia, Self-Harm Found to Be Linked in Older Adults.”

(Image: iStock/MJFelt)


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