Association of Cognitive Impairments and Alzheimer’s Disease and Related Dementias With Hospital and Skilled Nursing Facility Utilization Among Community-Dwelling Older Adults

Abstract

This observational cohort study examined the association between Alzheimer’s disease and related dementias (ADRD) and hospital and skilled nursing facility (SNF) utilization among community-dwelling older adults aged 65 and older. Using four waves of longitudinal survey data from the 2016–2022 Health and Retirement Study conducted by the University of Michigan and multivariate, individual-level regressions, we found that the cognitive impairment but no dementia (CIND) and ADRD groups exhibited similar patterns in hospitalizations, hospital visits, and total hospital days compared to the normal cognition group. However, CIND was significantly associated with increased odds of SNF stays (odds ratio [OR], 1.22) and a higher number of SNF visits (incidence rate ratio [IRR], 1.45) than the normal cognition group. Higher odds of any SNF stay (OR, 1.26) and number of SNF visits (IRR, 1.45) were also observed for ADRD compared to normal cognition. These findings suggest that CIND or ADRD was not associated with hospital use but was significantly associated with increased SNF use.

Keywords

Alzheimer’s disease and related dementias hospital utilization skilled nursing facility community-dwelling older adults

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