Abstract
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 language | English |
|---|---|
| Pages (from-to) | 1397-1404 |
| Number of pages | 8 |
| Journal | Journal of Alzheimer's Disease |
| Volume | 94 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2023 |
Bibliographical note
Funding Information:Drs. Bayer, Erqou, Kunicki, Singh, Bozzay, McGeary, Zullo, Wu, Gravenstein, and Rudolph and Ms. Jiang are employees of the US Department of Veterans Affairs. Drs. Rudolph, Gravenstein, Zullo, and Eqou and Ms. Jiang are funded by the VA Health Services Research and Development Center of Innovation in Long Term Services and Supports (CIN-13-419) and Drs. Erqou and Rudolph are funded by the Providence Evidence Synthesis Program (ESP-22-116). Dr. Zullo was funded, in part, by National Institute on Aging awards R01AG077620, R01AG079295, and R01AG065722-03S1.
Funding Information:
Drs. Bayer, Erqou, Kunicki, Singh, Bozzay, McGeary, Zullo, Wu, Gravenstein, and Rudolph and Ms. Jiang are employees of the US Department of Veterans Affairs. Drs. Rudolph, Gravenstein, Zullo, and Eqou and Ms. Jiang are funded by the VA Health Services Research and Development Center of Innovation in Long Term Services and Supports (CIN-13-419) and Drs. Erqou and Rudolph are funded by the Providence Evidence Synthesis Program (ESP-22-116). Dr. Zullo was funded, in part, by National Institute on Aging awards R01AG077620, R01AG079295, and R01AG065722-03S1.
Publisher Copyright:
© 2023-IOS Press. All rights reserved.
Keywords
- Alzheimer's disease
- cognition
- dementia diagnosis
- heart failure
- multimorbidity
- multiple chronic conditions
- neurocognitive disorders
- nursing homes
- veterans
ASJC Scopus subject areas
- Neuroscience (all)
- Clinical Psychology
- Geriatrics and Gerontology
- Psychiatry and Mental health
