Patients with Alzheimer’s disease die more often after an ICU stay, and are less likely to be discharged home than patients without Alzheimer’s disease, according to a group of researchers.1
“Critically ill people living with dementia had much worse outcomes than anticipated,” reports Malaz Boustani, MD, MPH, one of the study authors and a research scientist at the Indiana University Center for Aging Research at Regenstrief Institute.
Boustani and colleagues compared discharge location (home or other facilities) and subsequent mortality for adults older than age 67 years, with and without Alzheimer’s disease, with a first ICU admission in 2018, and who were enrolled in Medicare Advantage. Of 145,342 adults, 10.5% had Alzheimer’s disease.
Only 37.6% of patients with Alzheimer’s disease were discharged home vs. 68.6% of patients without Alzheimer’s disease.
Among patients with Alzheimer’s disease, the rates of death in the same month as discharge and death in the 12 months after discharge were twice as common as patients without Alzheimer’s disease.
Researchers suggested clinicians should consider early and timely palliative care services instead of the ICU. Potential obstacles include the availability of palliative care and geriatric inpatient services, as well as the high recognized rate of dementia in primary care and hospital settings. “Early exposure to palliative care may improve both survivability and quality of life for these vulnerable people, and may reduce hospital-acquired infections,” Boustani says.
REFERENCE
1. Davis-Ajami ML, Chang CH, Gupta S, et al. Mortality and discharge location of intensive care patients with Alzheimer disease and related dementia. Am J Crit Care 2023;32:249-255.
Consider early and timely palliative care services instead of the ICU. Early exposure to palliative care may improve both survivability and quality of life, and may lower the risk of hospital-acquired infections.
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