title: Dementia: A risk factor for burns in the elderly.
abstract: BACKGROUND
  Older people are disproportionately at risk of burn and have a high risk of dementia; however the impact of dementia on risk of burn is unknown.
  
  
  METHODS
  Linked hospitalisation and death records for individuals aged 65 years and older admitted to a NSW hospital for a burn over the ten year period 2003-2012 were analysed. Demographic and burn characteristics and health outcomes were compared for people with and without dementia. Incidence rates were calculated per 100,000 population and negative binomial regression was used to examine temporal trends.
  
  
  RESULTS
  Of the 1535 older people hospitalised for a burn, 11.0% had a record of dementia. The age-standardised incidence rate for people with dementia was 22.7 per 100,000, and for people without dementia was 14.2 per 100,000 population, an incident rate ratio (IRR) of 1.6 (95%CI 1.3-2.0, p<0.0001). There was no significant change in rates over time. People with dementia were more likely to be admitted with burns to the trunk and have greater than 20% total body surface area (TBSA) burn. Mean length of stay (LOS) was more than double (24 vs 12 days) and 30-day mortality three times higher (15.4% vs 5.1%) for people with dementia. Adjusting for differences in age, sex, TBSA, inhalation injury, comorbidities and complications eliminated the increased mortality but not the difference in LOS. People with dementia were more likely to have been burnt by hot tap water (RR 2.3; 95%CI 1.8-2.8, p<0.0001) and ignition of clothing/nightwear (RR 2.6; 95% CI 1.2-5.4, p=0.0149) and to have sustained the burn in residential aged care (20.0%).
  
  
  CONCLUSIONS
  Burns in people with dementia are significant injuries, which have not decreased over the past ten years despite prevention efforts to reduce burns in older people. Targeted prevention education in the home and residential aged care facilities is warranted.
authors.affiliation: Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia. Electronic address: l.harvey@neura.edu.au.
authors.forename: Lara
authors.initials: L
authors.lastname: Harvey
authors.affiliation: Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, NSW 2109, Australia. Electronic address: r.mitchell@mq.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mitchell
authors.affiliation: Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, Faculty of Medicine, Level 3, AGSM Building, UNSW, Sydney 2052, Australia; Centre for Healthy Brain Ageing, NPI, Euroa Centre, School of Psychiatry, UNSW Medicine, Sydney, NSW 2031, Australia. Electronic address: h.brodaty@unsw.edu.au.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, Faculty of Medicine, Level 3, AGSM Building, UNSW, Sydney 2052, Australia; Centre for Healthy Brain Ageing, NPI, Euroa Centre, School of Psychiatry, UNSW Medicine, Sydney, NSW 2031, Australia. Electronic address: b.draper@unsw.edu.au.
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.affiliation: Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; Prince of Wales Clinical School, UNSW Medicine, UNSW, Sydney, NSW 2031, Australia. Electronic address: j.close@neura.edu.au.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Close
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002056:Burns / Q000453:epidemiology*; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016247:Information Storage and Retrieval; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D012307:Risk Factors; D015208:Smoke Inhalation Injury / Q000453:epidemiology; D015599:Trauma Severity Indices
keywords: Burns; Burns prevention; Death; Dementia; Elderly; Hospitalisations