心力衰竭住院后入住养老院的退伍军人新发痴呆诊断的发生率。
Incidence of New Dementia Diagnosis in Veterans Admitted to Nursing Homes After Heart Failure Hospitalization.
机构信息
Providence VA Medical Center, Long-Term Services and Supports Center of Innovation, Providence, RI, USA.
Warren Alpert Medical School of Brown University, Division of Geriatrics and Palliative Medicine, Providence, RI, USA.
出版信息
J Alzheimers Dis. 2023;94(4):1397-1404. doi: 10.3233/JAD-221300.
BACKGROUND
Hospitalization with heart failure (HF) may signal an increased risk of Alzheimer's disease and related dementias (ADRD). Nursing homes routinely assess cognition but the association of these results with new ADRD diagnosis in a population at high risk of ADRD is not known.
OBJECTIVE
To determine the association between nursing home cognitive assessment results and new diagnosis of dementia after heart failure hospitalization.
METHODS
This retrospective cohort study included Veterans hospitalized for HF and discharged to nursing homes, from 2010 to 2015, without a prior diagnosis of ADRD. We determined mild, moderate, or severe cognitive impairment using multiple items of the nursing home admission assessment. We used Cox regression to determine the association of cognitive impairment with new ADRD diagnosis during 365 days of follow-up.
RESULTS
The cohort included 7,472 residents, new diagnosis of ADRD occurred in 4,182 (56%). The adjusted hazard ratio of ADRD diagnosis was 4.5 (95% CI 4.2, 4.8) for the mild impairment group, 5.4 (95% CI 4.8, 5.9) for moderate impairment, and 4.0 (95% CI 3.2, 5.0) for severe impairment compared to the cognitively intact group.
CONCLUSION
New ADRD diagnoses occurred in more than half of Veterans with HF admitted to nursing homes for post-acute care.
背景
心力衰竭（HF）住院可能预示着阿尔茨海默病和相关痴呆症（ADRD）的风险增加。疗养院通常会评估认知能力，但这些结果与在 ADRD 高风险人群中发生的新 ADRD 诊断之间的关联尚不清楚。
目的
确定疗养院认知评估结果与心力衰竭住院后新发痴呆症之间的关系。
方法
这项回顾性队列研究纳入了 2010 年至 2015 年因 HF 住院并出院至疗养院但无 ADRD 既往诊断的退伍军人。我们使用疗养院入院评估的多项指标来确定轻度、中度或重度认知障碍。我们使用 Cox 回归来确定认知障碍与 365 天随访期间新发 ADRD 诊断之间的关系。
结果
队列包括 7472 名居民，新发 ADRD 诊断为 4182 例（56%）。轻度认知障碍组、中度认知障碍组和重度认知障碍组的 ADRD 诊断的调整后危险比分别为 4.5（95%CI 4.2，4.8）、5.4（95%CI 4.8，5.9）和 4.0（95%CI 3.2，5.0），与认知正常组相比。
结论
心力衰竭入住疗养院接受急性后护理的退伍军人中，超过一半的人新发 ADRD 诊断。
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