No abstract

No abstract

Background and purpose To study the association between Alzheimer's disease and related syndromes (ADRS) and the incidence of short‐stay hospitalizations from the year before (Y−1) to 4 years after (Y1–Y4) ADRS identification in the healthcare system. Methods Among all beneficiaries of the French health insurance general scheme aged 40 years or more, those with an incident ADRS in 2011, identified through long‐term disease registry, hospitalization diagnoses or ADRS‐specific drug delivery, were matched with beneficiaries without ADRS of the same age, gender and residence area. The annual incidence rates of all‐cause hospitalizations (excluding those with a diagnosis code of ADRS) were compared between individuals with or without ADRS using incidence ratios (IRs) globally and by age, gender, deprivation index and modified Charlson score. We also studied cause‐specific hospitalizations using patients’ diagnoses and procedure codes. Results A total of 90 871 subjects with and 90 871 subjects without ADRS were included (mean age 79.6 years, 66% females). From Y−1 to Y4, incidence rates were significantly higher in subjects with ADRS than in those without for all‐cause hospitalization [IR(Y−1) = 1.73; 95% confidence intervals, 1.71–1.75; IR(Y4) = 1.37; 95% confidence intervals, 1.35–1.39], hospitalizations for social reasons [IR(Y−1) = 4.28; IR(Y4) = 2.70], fall [IR(Y−1) = 5.36; IR(Y4) = 2.59], injury [IR(Y−1) = 2.71; IR(Y4) = 2.09] and infection [IR(Y−1) = 2.04; IR(Y4) = 2.07]. The inverse was observed for hospitalizations for cataract surgery [IR(Y−1)=0.73; IR(Y4) = 0.51] or total hip prosthesis after 2 years [IR(Y4) = 0.72]. Conclusions Incident ADRS cases were associated with a higher incidence of hospitalization, but these subjects underwent some common non‐emergency surgeries less frequently. Future studies need to assess the clinical impact of these differences.

Objectives A frequent late Alzheimer's Disease and Related Diseases (ADRD) identification is described and may induce erratic health resource use. We aimed to describe healthcare use patterns preceding ADRD identification. Methods We studied persons aged 65 or older, identified with incident ADRD in 2012 in the French health insurance database. Healthcare use covering a wide range of care in ambulatory and hospital settings during the period ranging from 18 to six months before ADRD identification was studied. The main dimensions of healthcare use patterns before ADRD identification were investigated in three age groups (65–74, 75–84, ≥85) through a multiple correspondence analysis. These dimensions were secondarily interpreted according to the 5‐year healthcare trajectory following ADRD identification, qualified as favorable (or not) by experts in the field. Results This research studied 36,990 subjects. Four dimensions raised in each age group. Two dimensions' interpretations were retrieved in all age groups: intensity of healthcare use, functional dependency. However, their rank differed along with the qualification of the future healthcare trajectory. Some specificities appeared in some age group. In the 65–74 and 75–84 years groups, there were dimensions reflecting healthcare use related to psychiatric or psycho‐behavioral disorders. In the ≥85 group, two dimensions reflected dependency related to other comorbidities, and organised medical follow‐up. Conclusion Several dimensions emerged in line with erratic trajectories before ADRD identification. They underlined the need for actions towards ADRD identification.