Outcomes of dementia: Systematic review and meta-analysis of hospital administrative database studies

Rao, Ahsan; Suliman, Amna; Vuik, Sabine; Aylin, Paul; Darzi, Ara

doi:10.1016/j.archger.2016.06.008

Cited by 78 publications

(67 citation statements)

References 30 publications

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“…A recently published meta-analysis investigating mortality in mental disorders including 43 studies of depression showed that the mortality was almost two times higher in people with depression as compared to the general population [13]. Similarly, dementia has been associated with increased mortality from another meta-analysis [16]. …”

Section: Introductionmentioning

confidence: 99%

Major Depressive Symptoms Increase 3-Year Mortality Rate in Patients with Mild Dementia

Petersen

Waldorff

Siersma

et al. 2017

International Journal of Alzheimer's Disease

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Depression and dementia are commonly concurrent and are both associated with increased mortality among older people. However, little is known about whether home-dwelling patients newly diagnosed with mild dementia coexisting with depressive symptoms have excess mortality. We conducted a post hoc analysis based on data from the Danish Alzheimer's Intervention Study of 330 individuals who were diagnosed with mild dementia within the past 12 months. Thirty-four patients were identified with major depressive symptoms (MD-S) at baseline. During the 3-year follow-up period, 56 patients died, and, among them, 12 were with MD-S at baseline. Multivariable analysis adjusting for the potential confounders (age, sex, smoking status, alcohol consumption, education, BMI, household status, MMSE, CCI, QoL-AD, NPIQ, ADSC-ADL, medication, and RCT allocation) showed that patients with MD-S had a 2.5-fold higher mortality as compared to the patients without or with only few depressive symptoms. Our result revealed that depression is possibly associated with increased mortality in patients with mild dementia. Given that depression is treatable, screening for depression and treatment of depression can be important already in the earliest stage of dementia to reduce mortality.

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Section: Introductionmentioning

confidence: 99%

Major Depressive Symptoms Increase 3-Year Mortality Rate in Patients with Mild Dementia

Petersen

Waldorff

Siersma

et al. 2017

International Journal of Alzheimer's Disease

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“…However, there was no analysis of the impact of CI on postoperative outcomes. Similarly, a review by Rao et al examined the outcomes of patients with dementia versus patients without dementia [38]. However, that study focused on patients with diagnosed dementia, as opposed to cognitive impairment, which is both more prevalent and less clinically apparent.…”

Section: Tablementioning

confidence: 99%

Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review

Viramontes

Erfe

et al. 2019

Journal of Clinical Anesthesia

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Total hip arthroplasty (THA) is a common surgical procedure in the elderly. Varying degrees of cognitive impairment (CI) are frequently seen in this patient population. To date, there has been no systematic review of the literature specifically examining the impact of CI on outcomes after elective THA. The aim of this systematic review was to identify studies that compare the postoperative outcomes of patients with and without CI after undergoing elective primary THA. Design: We conducted a systematic review of prospective and retrospective studies. A systematic literature review was conducted by searching MEDLINE, PubMed, and Embase from between January 1, 1997 and January 1, 2018. A total of 234 articles were reviewed and 22 studies were selected. Setting: Operating room and short-term and long-term postoperative recovery up to 2 years. Patients: Patients with CI who underwent an elective primary THA that required general anesthesia with a comparator group of patients who did not have dementia. Interventions: Patients who underwent elective primary total hip arthroplasty. Measurements: Outcomes included post-operative delirium (POD), mortality and other complications, discharge disposition, length of stay (LOS), mortality, short-term (30 days) and long-term (1 month-2 years) complications. Main results: 22 studies with 5,705,302 participants were included in the systematic review. Sample sizes varied greatly, ranging from 14 to 2,924,995 participants. There was an association between patients with CI and an increase in POD, in-hospital mortality, complications during hospitalization, non-routine disposition, LOS, mortality between 1 month to 2 years, and worse postoperative functional status. Conclusions: We demonstrate that there are strong associations between patients with pre-existing CI undergoing THA and increased POD, hospital mortality, hospital complications, and hospital LOS. We report good quality evidence linking complications after THA to preexisting CI. Screening for CI can improve care and better predict the risk of developing postoperative complications such as delirium. Further investigations can address perioperative factors that can help reduce complications and show the utility of more widespread assessment of preoperative cognitive impairment.

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“…Obwohl Patienten mit Demenz je Aufenthalt einen vergleichbaren Charlson-Komorbiditäts-Score und eine ähnliche Verweildauer aufwiesen, erhielten sie je Krankenhausaufenthalt weniger diagnostische und therapeutische Leistungen als die Vergleichsgruppe. DiesdecktsichmitResultatenvergleichbarerStudien [22].Häufigerwarenhingegendie"ErgänzendenLeistungen".Darunterfallenbspw.aufwendigePflegemaßnahmen(▶ Tab. 5)oderdieBehandlung von behavioralen und psychischen Symptomen.…”

Section: Akutstationäre Versorgungunclassified

“…5)oderdieBehandlung von behavioralen und psychischen Symptomen. Die Gründe für eine geringere Inanspruchnahme sind multifaktoriell: Erstens ist denkbar, dass bei (fortgeschrittener) Demenz eher auf Maßnahmen verzichtet wird, da man sich von ihnen möglicherweise keine Verbesserungen des Gesundheitszustandes erwartet [22]. ZweitenskönntenMaßnahmenunterlassenwerden,dadashäufigere Auftreten von behavorialen und psyschischen Symptomen oder Delirien bei Patienten mit Demenz die Durchführung von diagnostischen und therapeutischen Maßnahmen erschweren, aufwendig oder unmöglich machen.…”

Section: Akutstationäre Versorgungunclassified

Administrative Prävalenz und Versorgungssituation der Demenz im Krankenhaus – Eine versorgungsepidemiologische Studie basierend auf GKV-Daten sächsischer Versicherter

Motzek

Werblow²,

Schmitt³

et al. 2018

Gesundheitswesen

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Outcomes of dementia: Systematic review and meta-analysis of hospital administrative database studies

Abstract: Compared to older adult population, patients with dementia had poorer outcome. Despite higher mortality rate and readmission rate, they underwent fewer interventions and procedures.

Cited by 78 publications

References 30 publications

Major Depressive Symptoms Increase 3-Year Mortality Rate in Patients with Mild Dementia

Major Depressive Symptoms Increase 3-Year Mortality Rate in Patients with Mild Dementia

Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review

Administrative Prävalenz und Versorgungssituation der Demenz im Krankenhaus – Eine versorgungsepidemiologische Studie basierend auf GKV-Daten sächsischer Versicherter

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