Incidence of New Dementia Diagnosis in Veterans Admitted to Nursing Homes after Heart Failure Hospitalization

Thomas A. Bayer, Lan Jiang, Sebhat Erqou, Zachary J. Kunicki, Mriganka Singh, Matthew Duprey, Melanie Bozzay, John E. McGeary, Andrew R. Zullo, Wen Chih Wu, Stefan Gravenstein, James L. Rudolph

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish
Pages (from-to)1397-1404
Number of pages8
JournalJournal of Alzheimer's Disease
Issue number4
StatePublished - 2023

Bibliographical note

Publisher Copyright:
© 2023-IOS Press. All rights reserved.


  • Alzheimer's disease
  • cognition
  • dementia diagnosis
  • heart failure
  • multimorbidity
  • multiple chronic conditions
  • neurocognitive disorders
  • nursing homes
  • veterans

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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