title: Nationwide Inpatient Prevalence, Predictors, and Outcomes of Alzheimer's Disease among Older Adults in the United States, 2002-2012.
abstract: In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of Alzheimer's disease (AD) are largely unknown. We used data on older adults (60+ y) from the Nationwide Inpatient Sample (NIS) 2002-2012. AD prevalence was ∼3.12% in 2012 (total weighted discharges with AD ± standard error: 474, 410 ± 6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR = 1.67, 95% CI: 1.63-1.71, p <  0.001), fluid/electrolyte disorders (OR = 1.25, 95% CI: 1.22-1.27, p <  0.001), weight loss (OR = 1.26, 95% CI: 1.22-1.30, p <  0.001), and psychosis (OR = 2.59, 95% CI: 2.47-2.71, p <  0.001), with mean total co-morbidities increasing over time. AD was linked to higher MR and longer LOS, but lower TC. TC rose in AD, while MR and LOS dropped markedly over time. In AD, co-morbidities predicting simultaneously higher MR, TC, and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders, and weight loss. In sum, co-morbidities and TC increased over time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD.
authors.affiliation: National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
authors.forename: May A
authors.initials: MA
authors.lastname: Beydoun
authors.affiliation: Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Hind A
authors.initials: HA
authors.lastname: Beydoun
authors.affiliation: National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Gamaldo
authors.affiliation: National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
authors.forename: Ola S
authors.initials: OS
authors.lastname: Rostant
authors.affiliation: National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
authors.forename: Greg A
authors.initials: GA
authors.lastname: Dore
authors.affiliation: National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Zonderman
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Shaker M
authors.initials: SM
authors.lastname: Eid
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011618:Psychotic Disorders / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
keywords: Alzheimer’s disease; co-morbidity; health care cost; inpatient sample; length of stay; mortality; older adults