Patients with OA, dementia have fewer ‘hospital-free years’ than those without dementia
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Patients with osteoarthritis who developed dementia were more likely than their counterparts without dementia to be hospitalized for ambulatory care services, according to a speaker at the 2022 OARSI World Congress.
Ali Kiadaliri, PhD, of Lund University, in Sweden, noted that dementia is an important comorbidity of OA that has not yet been adequately explored.
“These coexisting conditions can complicate disease management and result in poor quality of care that can lead to unnecessary and avoidable health care use,” he said.
The key parameter of health care use assessed by the group was hospital admissions for ambulatory care sensitive conditions (ACSCs), according to Kiadaliri.
The current observational, population-based study included individuals in Sweden with an age range of 50 to 99 years accrued between 1998 and 2009. They were followed from Jan. 1, 2010, to either their 100th birthday, death or hospitalization through Dec. 31, 2019.
“In this study we aimed to investigate associations between incipient dementia and hospitalizations for ACSCs among people with OA in the peripheral joints,” Kiadaliri said.
The final analysis included 57,731 individuals with OA and no dementia at baseline overall.
According to Kiadaliri, 8% of this group was ultimately diagnosed with dementia. Factors associated with dementia diagnosis included older age, female sex, lower education status, lower income and more comorbidities at baseline.
The researchers created two models to assess rates of hospitalizations for ACSCs.
“In the first one, we assumed no one had dementia, while in the second one we assumed everyone had dementia,” Kiadaliri said. “The difference between these two would reflect the difference in hospital-free years associated with incipient dementia.”
Results showed that people with dementia had higher crude rates of hospital admissions for ACSCs, compared to those without dementia, at 57.8 per 100 person/years (95% CI, 53.1-63.0) vs. 32.9 per 100 person/years (95% CI, 32.3-33.5), according to Kiadaliri.
“In absolute terms, dementia was associated with 6 fewer hospital-free years for ACSCs,” he said.
Importantly, older patients with OA who had dementia received better ambulatory care services than younger patients with OA who had dementia, according to the findings. In addition, patients with acute ACSCs were more likely to be admitted to the hospital than those with chronic ACSCs.
“Our results called for improvement in the continuity of care for OA persons with dementia,” Kiadaliri concluded.
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Kiadaliri A. Incipient dementia and risk of hospital admission for ambulatory care sensitive conditions in osteoarthritis in the peripheral joints. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting).
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