title: Influence of Incipient Dementia on Hospitalization for Primary Care Sensitive Conditions: A Population-Based Cohort Study.
abstract: Studies have reported that moderate/severe stages of dementia are linked to increased hospitalization rates, but little is known about the influence of incipient dementia on hospitalizations for primary care sensitive conditions (PCSCs).
  
  
  
  To examine the associations between incipient dementia and hospitalization outcomes, including all-cause and PCSC hospitalization.
  
  
  
  A total of 2,268 dementia-free participants in the Swedish National study on Aging and Care-Kungsholmen were interviewed and clinically examined at baseline. Participants aged ≥78 years were followed for 3 years, and those aged 60-72 years, for 6 years. Number of hospitalizations was retrieved from the National Patient Register. Dementia was diagnosed in accordance with Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Hospitalization outcomes were compared in participants who did and did not develop dementia. Zero-inflated Poisson regressions and logistic regressions were used in data analysis.
  
  
  
  During the follow-up, 175 participants developed dementia. The unadjusted PCSC admission rate was 88.2 per 1000 person-years in those who developed dementia and 25.6 per 1000 person-years in those who did not. In the fully adjusted logistic regression model, incipient dementia was associated with an increased risk of hospitalization for PCSCs (OR = 2.3, 95% CI 1.3-3.9) but not with the number of hospitalizations or with all-cause hospitalization. Risks for hospitalization for diabetes, congestive heart failure, and pyelonephritis were higher in those who developed dementia than in those who did not. About 10% participants had a PCSC hospitalization attributable to incipient dementia.
  
  
  
  People with incipient dementia are more prone to hospitalization for PCSCs but not to all-cause hospitalization.
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Clément
authors.initials: C
authors.lastname: Pimouguet
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Debora
authors.initials: D
authors.lastname: Rizzuto
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Fastbom
authors.affiliation: Stockholm Gerontology Research Center, Stockholm, Sweden.
authors.forename: Mårten
authors.initials: M
authors.lastname: Lagergren
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Stockholm Gerontology Research Center, Stockholm, Sweden.
authors.forename: Laura
authors.initials: L
authors.lastname: Fratiglioni
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Epidemiology & Biostatistics, Public Health School, Tianjin Medical University, China.
authors.forename: Weili
authors.initials: W
authors.lastname: Xu
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003704:Dementia / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012042:Registries; D012306:Risk; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology
keywords: Dementia; hospitalization longitudinal follow-up; population based study