Incipient dementia and avoidable hospital admission in persons with osteoarthritis
(2023) In Osteoarthritis and Cartilage Open 5(1).- Abstract
OBJECTIVE: To investigate the associations between incipient dementia (ID) and hospitalization for ambulatory care sensitive conditions (ACSCs) among people with osteoarthritis (OA) of the peripheral joints.
METHODS: Among individuals aged 51-99 years residing in Skåne, Sweden, in 2009, we identified those with a doctor-diagnosed OA and no dementia during 1998-2009 (n = 57,733). Treating ID as a time-varying exposure, we followed people from January 1, 2010 or their 60th birthday (whichever occurred last) until hospitalization for ACSCs, death, 100th birthday, relocation outside Skåne, or December 31, 2019 (whichever occurred first). Using age as time scale, we applied flexible parametric survival models, adjusted for... (More)
OBJECTIVE: To investigate the associations between incipient dementia (ID) and hospitalization for ambulatory care sensitive conditions (ACSCs) among people with osteoarthritis (OA) of the peripheral joints.
METHODS: Among individuals aged 51-99 years residing in Skåne, Sweden, in 2009, we identified those with a doctor-diagnosed OA and no dementia during 1998-2009 (n = 57,733). Treating ID as a time-varying exposure, we followed people from January 1, 2010 or their 60th birthday (whichever occurred last) until hospitalization for ACSCs, death, 100th birthday, relocation outside Skåne, or December 31, 2019 (whichever occurred first). Using age as time scale, we applied flexible parametric survival models, adjusted for confounders, to assess the associations between ID and hospitalization for ACSCs.
RESULTS: There were 58 and 33 hospitalizations for ACSCs per 1000 person-years among OA people with and without ID, respectively. The association between ID and hospitalization for any ACSCs was age-dependent with higher risk in ages<86 years and lower risks in older ages. Between ages 60 and 100 years, persons with ID had, on average, 5.8 (95% CI 0.9, 10.7), 1.6 (-2.6, 5.9) and 3.1 (2.3, 4.0) fewer hospital-free years for any, chronic and acute ACSCs, respectively, compared with persons without ID.
CONCLUSIONS: Among persons with OA, while ID was associated with increased risks of hospitalization for ACSCs in younger ages, it was associated with decreased risk in oldest ages. These results suggest the need for improvement in quality of ambulatory care including the continuity of care for people with OA having dementia.
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- author
- Kiadaliri, Ali LU ; Lohmander, L Stefan LU ; Dahlberg, Leif E LU and Englund, Martin LU
- organization
-
- Lund OsteoArthritis Division - Clinical Epidemiology Unit (research group)
- Centre for Economic Demography
- EpiHealth: Epidemiology for Health
- Lund OsteoArthritis Division - Molecular marker research group (research group)
- Lund OsteoArthritis Division - From molecule to clinical implementation (research group)
- LU Profile Area: Proactive Ageing
- publishing date
- 2023-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Osteoarthritis and Cartilage Open
- volume
- 5
- issue
- 1
- article number
- 100341
- publisher
- Elsevier
- external identifiers
-
- scopus:85162377985
- pmid:36798737
- ISSN
- 2665-9131
- DOI
- 10.1016/j.ocarto.2023.100341
- language
- English
- LU publication?
- yes
- additional info
- © 2023 The Author(s).
- id
- d8d584f8-2dba-4be8-b9cd-c8257466cabe
- date added to LUP
- 2023-02-24 13:25:23
- date last changed
- 2024-07-27 05:49:30
@article{d8d584f8-2dba-4be8-b9cd-c8257466cabe, abstract = {{<p>OBJECTIVE: To investigate the associations between incipient dementia (ID) and hospitalization for ambulatory care sensitive conditions (ACSCs) among people with osteoarthritis (OA) of the peripheral joints.</p><p>METHODS: Among individuals aged 51-99 years residing in Skåne, Sweden, in 2009, we identified those with a doctor-diagnosed OA and no dementia during 1998-2009 (n = 57,733). Treating ID as a time-varying exposure, we followed people from January 1, 2010 or their 60th birthday (whichever occurred last) until hospitalization for ACSCs, death, 100th birthday, relocation outside Skåne, or December 31, 2019 (whichever occurred first). Using age as time scale, we applied flexible parametric survival models, adjusted for confounders, to assess the associations between ID and hospitalization for ACSCs.</p><p>RESULTS: There were 58 and 33 hospitalizations for ACSCs per 1000 person-years among OA people with and without ID, respectively. The association between ID and hospitalization for any ACSCs was age-dependent with higher risk in ages<86 years and lower risks in older ages. Between ages 60 and 100 years, persons with ID had, on average, 5.8 (95% CI 0.9, 10.7), 1.6 (-2.6, 5.9) and 3.1 (2.3, 4.0) fewer hospital-free years for any, chronic and acute ACSCs, respectively, compared with persons without ID.</p><p>CONCLUSIONS: Among persons with OA, while ID was associated with increased risks of hospitalization for ACSCs in younger ages, it was associated with decreased risk in oldest ages. These results suggest the need for improvement in quality of ambulatory care including the continuity of care for people with OA having dementia.</p>}}, author = {{Kiadaliri, Ali and Lohmander, L Stefan and Dahlberg, Leif E and Englund, Martin}}, issn = {{2665-9131}}, language = {{eng}}, number = {{1}}, publisher = {{Elsevier}}, series = {{Osteoarthritis and Cartilage Open}}, title = {{Incipient dementia and avoidable hospital admission in persons with osteoarthritis}}, url = {{http://dx.doi.org/10.1016/j.ocarto.2023.100341}}, doi = {{10.1016/j.ocarto.2023.100341}}, volume = {{5}}, year = {{2023}}, }