Causes and outcomes of hospitalization in Lewy body dementia: A retrospective cohort study

Spears, C. Chauncey; Besharat, Amir; Monari, Erin H.; Martínez-Ramírez, Daniel; Almeida, Leonardo; Armstrong, Melissa J.

doi:10.1016/j.parkreldis.2019.03.014

Cited by 19 publications

(20 citation statements)

References 29 publications

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“…This awareness can ensure relevant information, resources and support specific to the type of dementia. For example, antipsychotics, commonly prescribed for people with intellectual disability, can cause severe reaction in Lewy body dementia (Chauncey Spears et al., 2019). Whilst not affecting the study findings, this would have provided greater clarity over biographical data.…”

Section: Resultsmentioning

confidence: 99%

A person‐centred approach to implementation of psychosocial interventions with people who have an intellectual disability and dementia—A participatory action study

Watchman

Mattheys

McKernon

et al. 2020

Research Intellect Disabil

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The World Health Organization estimates that 200 million people worldwide have an intellectual disability. Of this number, approximately 250,000 families in the United States, 60,000 in the UK and 45,000 in Canada are affected by Down syndrome (World Health Organisation, 2018). As recently as the 1980s, life expectancy remained below 20 years for people with Down syndrome; this is now over 60 years in developed countries (Ng, Flygare Wallén, & Ahlström, 2017). This has resulted in awareness that dementia disproportionality affects people with Down syndrome at an earlier age, average fifty-five, and is associated with mortality in 70% of adults (Hithersay et al., 2019). People with intellectual disabilities other than Down syndrome are also more likely to develop dementia earlier, on average approximately 10 years prior to that experienced by the population without an intellectual disability (British Psychological Society, 2015). Such demographics demonstrate the global importance of identifying appropriate support for people ageing with intellectual disability.

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Section: Resultsmentioning

confidence: 99%

A person‐centred approach to implementation of psychosocial interventions with people who have an intellectual disability and dementia—A participatory action study

Watchman

Mattheys

McKernon

et al. 2020

Research Intellect Disabil

View full text Add to dashboard Cite

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“…Because parkinsonian patients have higher rates of in-hospital complications [18][19][20], strategies and safety tips to prevent unnecessary hospitalization are covered. The team addresses advance care planning and provides anticipatory guidance for hospitalization during COVID-19, including a Parkinson's Foundation letter that functions as a surrogate advocate regarding PD medications and contraindications.…”

Section: Covid-19 Outreach Programmentioning

confidence: 99%

Novel Outreach Program and Practical Strategies for Patients with Parkinsonism in the COVID-19 Pandemic1

Sennott

Woo

Hess

et al. 2020

JPD

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The coronavirus disease 2019 (COVID-19) pandemic has upended daily life and neurologic care for most patients, including those with Parkinson’s disease and parkinsonism. Disruptions to routine care, high volumes of patient and caregiver calls, and our patients’ risk of infection and complications inspired a proactive COVID-19 outreach program. This program targets patients with advanced Parkinson’s disease and related disorders, specifically those who are homebound, receiving or eligible for palliative care, and/or lacking support networks. We describe the program and practical strategies providers can implement to support wellbeing and successful telehealth uptake during this time of social isolation and gradual reopening.

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“… 32 , 33 Neuropsychiatric symptoms like delirium, falls, and infections were identified as common admission reasons in Lewy body dementia while antipsychotics were fingered in longer hospital stays and poorer outcomes. 34 Geriatric patients with dementia had higher complication rates for UTI, pressure ulcers, pneumonia, and delirium when compared with geriatrics without dementia. 35 Also noteworthy is that falls, delirium, and comorbidities were published as leading reasons for hospitalization or admission diagnoses in dementia patients 36 , 37 , 38 while diabetes, pneumonia, UTI, and fall‐related fracture were significantly associated with prolonged admission and recurrence of admissions, 39 all overlapping with a number of our hospitalization outcome risk factors.…”

Section: Discussionmentioning

confidence: 91%

Risk factors and machine learning model for predicting hospitalization outcomes in geriatric patients with dementia

Wang

Ezeana

Wang

et al. 2022

A&D Transl Res & Clin Interv

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Introduction Geriatric patients with dementia incur higher healthcare costs and longer hospital stays than other geriatric patients. We aimed to identify risk factors for hospitalization outcomes that could be mitigated early to improve outcomes and impact overall quality of life. Methods We identified risk factors, that is, demographics, hospital complications, pre‐admission, and post‐admission risk factors including medical history and comorbidities, affecting hospitalization outcomes determined by hospital stays and discharge dispositions. Over 150 clinical and demographic factors of 15,678 encounters (8407 patients) were retrieved from our institution's data warehouse. We further narrowed them down to twenty factors through feature selection engineering by using analysis of variance (ANOVA) and Glmnet. We developed an explainable machine‐learning model to predict hospitalization outcomes among geriatric patients with dementia. Results Our model is based on stacking ensemble learning and achieved accuracy of 95.6% and area under the curve (AUC) of 0.757. It outperformed prevalent methods of risk assessment for encounters of patients with Alzheimer's disease dementia (ADD) (4993), vascular dementia (VD) (4173), Parkinson's disease with dementia (PDD) (3735), and other unspecified dementias (OUD) (2777). Top identified hospitalization outcome risk factors, mostly from medical history, include encephalopathy, number of medical problems at admission, pressure ulcers, urinary tract infections, falls, admission source, age, race, anemia, etc., with several overlaps in multi‐dementia groups. Discussion Our model identified several predictive factors that can be modified or intervened so that efforts can be made to prevent recurrence or mitigate their adverse effects. Knowledge of the modifiable risk factors would help guide early interventions for patients at high risk for poor hospitalization outcome as defined by hospital stays longer than seven days, undesirable discharge disposition, or both. The interventions include starting specific protocols on modifiable risk factors like encephalopathy, falls, and infections, where non‐existent or not routine, to improve hospitalization outcomes of geriatric patients with dementia. Highlights A total 15,678 encounters of Geriatrics with dementia with a final 20 risk factors. Developed a predictive model for hospitalization outcomes for multi‐dementia types. Risk factors for each type were identified including those amenable to interventions. Top factors are encephalopathy, pressure ulcers, urinary tract infection (UTI), falls, and admission source. With accuracy of 95.6%, our ensemble predictive model outperforms other models.

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Causes and outcomes of hospitalization in Lewy body dementia: A retrospective cohort study

Cited by 19 publications

References 29 publications

A person‐centred approach to implementation of psychosocial interventions with people who have an intellectual disability and dementia—A participatory action study

A person‐centred approach to implementation of psychosocial interventions with people who have an intellectual disability and dementia—A participatory action study

Novel Outreach Program and Practical Strategies for Patients with Parkinsonism in the COVID-19 Pandemic1

Risk factors and machine learning model for predicting hospitalization outcomes in geriatric patients with dementia

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