The Effects of Dementia in German Acute Care Hospitals

Dinkel, Reiner H.; Lebok, Uwe

doi:10.1159/000106649

Cited by 31 publications

(22 citation statements)

References 20 publications

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“…For example, Van Dijk et al [26], examining nursing home residents with unspecified diagnosis of dementia, have reported a greater number of associated diseases than among patients with no or minimal cognitive impairment. Similar evidence was provided by an in-hospital study [27], and among community-dwelling elderly [28]. Comorbidity was found to be higher among patients with dementia, and they were more likely to be diagnosed with congestive heart failure, anemia, and cerebrovascular diseases.…”

Section: Discussionsupporting

confidence: 76%

“…This has been documented among people living in the community [39][40][41], as well as in acute hospital [27] and long-term care settings [39,42], using different instruments for the screening of cognitive impairment. Although estimates of the risk of death among patients with AD have varied greatly, most studies, both institutional [43,44] and community-based studies [45,46], have suggested that it is moderately increased as opposed to unaffected people.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

Landi

Gambassi²,

Lapane

et al. 1999

Dement Geriatr Cogn Disord

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We conducted a retrospective cohort study to examine whether patients with Alzheimer’s disease (AD) or vascular dementia (VaD) differed in the number and type of associated comorbid conditions. In addition, we evaluated the impact of the severity of cognitive impairment on hospitalization and mortality of patients in each group. We studied 161,106 patients over age 65, with any degree of cognitive impairment, residing in any of 1,573 Medicare/Medicaid-certified nursing homes of 5 states of the USA between 1992 and 1995. Patients were assessed with the federally mandated Minimum Data Set (MDS). The MDS has been cross-linked to Medicare eligibility files and to the Medicare Provider Analysis and Review database. AD patients were younger, and more likely to be female and Caucasian than VaD patients. For comparable levels of cognitive impairment, AD patients appeared to have fewer comorbid conditions, including those that were not risk factors for VaD. In addition, patients with AD had decreased morbidity and mortality relative to patients with VaD. These findings support the hypothesis that AD patients are a healthier group of demented patients.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

Landi

Gambassi²,

Lapane

et al. 1999

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

show abstract

“…For example, Van Dijk et al [39], examining specifically nursing home residents with dementia, found they had more comorbidity relative to patients less cognitively impaired. In an in-hospital study, comorbidity, rate of infections and mortality were higher among patients with dementia, as opposed to age-matched patients with normal cognitive function [40]. Finally, Callahan et al [41] have reported that community-dwelling elderly with cognitive impairment were more likely to be diagnosed as having congestive heart failure, anemia and cerebrovascular diseases.…”

Section: Discussionmentioning

confidence: 94%

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

Landi

Gambassi²,

Lapane³

et al. 1998

Dement Geriatr Cogn Disord

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Cognitive impairment is associated with an increased mortality in older people. The prevalence and impact of comorbidity on functional status and mortality of demented patients has not been fully elucidated. Using a population-based data set, we describe the prevalence of cognitive impairment, functional status, principal comorbid conditions and 1-year survival for over 300,000 patients admitted to the nursing homes in five US states. Sixty-one percent of patients have some level of cognitive impairment, and this correlates with the degree of physical frailty. Severer cognitive impairment is associated with a higher mortality rate. Yet, patients with cognitive impairment appear to have fewer comorbid conditions and are less likely to receive medications and special treatments than residents with normal cognitive status. Additional studies are needed to understand whether demented patients may paradoxically be considered healthier or, instead, are only neglected.

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“…In addition, immune-complex deposits in ANCA-associated glomerulonephritis were shown to be associated with a larger amount of proteinuria, more frequent hypocomplementemia and greater glomerular hypercellularity, with a tendency toward worse renal outcomes [10,11,12]. In patients with typical immune-complex CrGN, such as lupus nephritis and post-streptococcal CrGN, the presence of ANCA has been shown to correlate with more glomerular necrosis and crescent formation [27]. It is postulated that a synergistic effect between ANCA and immune-complex deposition may exist, although the role of glomerular immune-complex deposition in AAV remains unclear.…”

Section: Discussionmentioning

confidence: 99%

The Immunopathological Spectrum of Crescentic Glomerulonephritis: A Survey of 106 Patients in a Single Chinese Center

et al. 2010

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Background: Crescentic glomerulonephritis (CrGN) is a severe form of glomerular injury. We retrospectively analyzed data from Chinese patients with CrGN in our center to characterize the immunopathological spectrum of CrGN. Methods: A total of 106 consecutive patients with biopsy-proven CrGN were recruited. CrGN was classified into 3 types according to findings on immunofluorescence microscopy; type I was defined as a linear deposition of immunoglobulins along the glomerular basement membrane (GBM), type II as a glomerular deposition of immune-complex and type III as a pauci-immune deposition. Results: A total of 17/106 (16.0%) patients were classified as type I, 43/106 (40.6%) as type II and 46/106 (43.4%) as type III. Serum antineutrophil cytoplasmic antibodies (ANCA) could be detected in 1/17 (5.9%) patient with type I, 11/43 (25.6%) patients with type II and 29/46 (63.0%) patients with type III CrGN (p < 0.001). Serum anti-GBM antibodies could be detected in 14/17 (82.4%) patients with type I, 2/43 (4.7%) patients with type II and 3/46 (6.5%) patients with type III. In type II CrGN, ANCA-positive patients were older (p < 0.001), had more multi-system involvement (p < 0.001) and more fibrinoid necrosis in renal histopathology than ANCA-negative patients (p = 0.003). Conclusions: Pauci-immune CrGN might be the most common type of CrGN in Northern China. There was much heterogeneity within each type of CrGN.

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The Effects of Dementia in German Acute Care Hospitals

Cited by 31 publications

References 20 publications

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

The Immunopathological Spectrum of Crescentic Glomerulonephritis: A Survey of 106 Patients in a Single Chinese Center

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