Diagnostic correlates of Alzheimer dementia in a U.S. Nationwide inpatient sample.
BACKGROUND
Alzheimer dementia (ALZ-D) is among the most frequent diseases in the elderly. Several somatic and psychiatric disorders have been suggested to be related to this diagnosis. The aim of this analysis of a large and representative U.S. nationwide inpatient sample (NIS) was to identify diagnostic correlates of ALZ-D in subjects aged 60 years and older.


METHODS
Of the total sample of 800,457 inpatient subjects ( approximately 2% of all inpatients in 2004), 315,244 individuals were 60 years or older. Of these, 9,572 (3.03%) received a diagnosis of ALZ-D, whereas 33,367 (10.59%) were diagnosed with osteoarthritis (OA) and served as a comparison group. Comparisons of potential somatic and psychiatric diagnostic correlates were conducted.


RESULTS
As determined by both univariate comparison and multivariate logistic regression analysis, after controlling for age and gender, subjects with ALZ-D (versus OA) had an overall higher rate of diagnoses of diseases of the vascular system (stroke: odds ratio 1.69; 95% confidence interval: 1.25-2.30) and psychotic and affective disorders (bipolar: 2.78 [1.26-6.12]; schizoaffective: 3.06 [2.10-4.47]). Increasing age and male gender were positively associated with the diagnosis of ALZ-D.


CONCLUSIONS
Many somatic diagnoses related to ALZ-D were confirmed by these analyses of the NIS. However, psychotic and affective disorders were identified to be equally significant correlates of ALZ-D, even in the presence of all other disorders. Prospective and longitudinal data are needed to investigate potential causal and temporal relationships between ALZ-D with somatic and psychiatric disorders.
Preuss
Ulrich W
UW
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle-Wittenberg, Germany. ulrich.preuss@medizin.uni-halle.de
Watzke
Stefan
S
Choi
Jae H
JH
D000341:Affective Disorders, Psychotic / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003628:Database Management Systems; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology; D014652:Vascular Diseases / Q000453:epidemiology