Prediction of general hospital admission in people with dementia: cohort study.
BACKGROUND
People with dementia are extremely vulnerable in hospital and unscheduled admissions should be avoided if possible.


OBJECTIVE
To identify any predictors of general hospital admission in people with dementia in a well-characterised national prospective cohort study.


METHODS
A cohort of 730 persons with dementia was drawn from the Scottish Dementia Research Interest Register (47.8% female; mean age 76.3 years, s.d. = 8.2, range 50-94), with a mean follow-up period of 1.2 years.


RESULTS
In the age- and gender-adjusted multivariable model (n = 681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per s.d. disadvantage 1.21, 95% CI 1.08-1.36) was identified as an independent predictor of admission to hospital.


CONCLUSIONS
Neuropsychiatric symptoms in dementia, measured using the Neuropsychiatric Inventory, predict non-psychiatric hospital admission of people with dementia. Further studies are merited to test whether interventions to reduce such symptoms might reduce unscheduled admissions to acute hospitals.
Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
Tom C
TC
Russ
Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
Mario A
MA
Parra
Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
Alison E
AE
Lim
Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
Emma
E
Law
Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
Peter J
PJ
Connelly
Tom C. Russ, PhD, MRCPsych, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, National Health Service (NHS) Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, and Division of Psychiatry, University of Edinburgh; Mario A. Parra, PhD, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK, and UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Alison E. Lim, Alzheimer Scotland Dementia Research Centre, University of Edinburgh; Emma Law, RMN, MPH, Peter J. Connelly, MD, FRCPsych, Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth; John M. Starr, PhD, FRCPEd, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, and Scottish Dementia Clinical Research Network, NHS Scotland, Murray Royal Hospital, Perth, and Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, UK.
John M
JM
Starr
D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications / Q000523:psychology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006769:Hospitals, General; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology