title: Care needs and clinical outcomes of older people with dementia: a population-based propensity score-matched cohort study.
abstract: OBJECTIVE
  To explore the healthcare resource utilization, psychotropic drug use and mortality of older people with dementia.
  
  
  METHODS
  A nationwide propensity score-matched cohort study.
  
  
  METHODS
  National Health Insurance Research database.
  
  
  METHODS
  A total of 32,649 elderly people with dementia and their propensity-score matched controls (n=32,649).
  
  
  METHODS
  Outpatient visits, inpatient care, psychotropic drug use, in-hospital mortality and all-cause mortality at 90 and 365 days.
  
  
  RESULTS
  Compared to the non-dementia group, a higher proportion of patients with dementia used inpatient services (1 year after index date: 20.91% vs. 9.55%), and the dementia group had more outpatient visits (median [standard deviation]: 7.00 [8.87] vs. 3.00 [8.30]). Furthermore, dementia cases with acute admission had the highest psychotropic drug utilization both at baseline and at the post-index dates (difference-in-differences: all <0.001). Dementia was associated with an increased risk of all-cause mortality (90 days, Odds ratio (OR)=1.85 [95%CI 1.67-2.05], p<0.001; 365 days, OR=1.59 [1.50-1.69], p<0.001) and in-hospital mortality (90 days, OR=1.97 [1.71-2.27], p<0.001; 365 days, OR=1.82 [1.61-2.05], p<0.001) compared to matched controls.
  
  
  CONCLUSIONS
  When older people with dementia are admitted for acute illnesses, they may increase their use of psychotropic agents and their risk of death, particularly in-hospital mortality.
authors.affiliation: Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Fei-Yuan
authors.initials: FY
authors.lastname: Hsiao
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Li-Ning
authors.initials: LN
authors.lastname: Peng
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Wen
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Geriatric Medicine Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Liang
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Pei-Ning
authors.initials: PN
authors.lastname: Wang
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003704:Dementia / Q000188:drug therapy*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D010045:Outpatients; D057216:Propensity Score; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs