title: A systematic review of intervention studies to prevent hospitalizations of community-dwelling older adults with dementia.
abstract: OBJECTIVE
  To conduct a systematic literature review to determine if there were any intervention strategies that had any measurable effect on acute-care hospitalizations among community-dwelling adults with dementia.
  
  
  METHODS
  Studies were identified by a professional research librarian and content experts.
  
  
  METHODS
  Community dwelling.
  
  
  METHODS
  Participants were diagnosed with dementia, severity ranging from mild to severe, and were recruited from health care and community agencies.
  
  
  METHODS
  A study met the inclusion criteria if it: (a) was published in English; (b) included a control or comparison group; (c) published outcome data from the intervention under study; (d) reported hospitalization as one of the outcomes; (e) included community-dwelling older adults; and (f) enrolled participants with dementia. Ten studies met all inclusion criteria.
  
  
  RESULTS
  Of the 10 studies included, most assessed health services use (ie, hospitalizations) as a secondary outcome. Participants were recruited from a range of health care and community agencies, and most were diagnosed with dementia with severity ratings ranging from mild to severe. Most intervention strategies consisted of face-to-face assessments of the persons living with dementia, their caregivers, and the development and implementation of a care plan. A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days.
  
  
  CONCLUSIONS
  The majority of studies included hospitalizations as a secondary outcome. Only 1 intervention was found to have an effect on hospitalizations. Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.
authors.affiliation: *Department of Medicine, School of Medicine, Division of Gerontology and Geriatric Medicine †Department of Health Services, School of Public Health, University of Washington, Seattle, WA ‡Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Healthy Aging Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA ∥Directors of Health Promotion and Education, Washington, DC.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Phelan
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Debnam
authors.forename: Lynda A
authors.initials: LA
authors.lastname: Anderson
authors.forename: Steven B
authors.initials: SB
authors.lastname: Owens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000534:rehabilitation*; D005260:Female; D006707:Homes for the Aged / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management / Q000458:organization & administration*