Predictive factors of acute hospitalization in 134 patients with Alzheimer's disease: a one year prospective study

Objective: To evaluate the frequency of and determine predictive factors for acute hospitalization in a prospective study of patients with Alzheimer's disease (AD).

Design: A one year prospective study.

Participants: 134 patients recruited from the memory clinic in Toulouse University Hospital, with AD diagnosed using the NINCDS-ADRDA criteria.

Measures: A comprehensive geriatric and neuropsychological assessment was conducted 6 monthly.

Results: Among the 134 patients included in this study, at one year follow up, 32 patients had at least one acute hospitalization. Patient-related variables predictive of acute hospitalization in the univariate analysis were: level of education, ADL-bathing, ADL-toileting, ADL-feeding, total ADL score, IADL A scale (daily upkeep), history of falls, and level of behavioural disorder as measured by the Cohen scale. In the multivariate regression model, two variables were associated with acute hospitalization: dependency for ADL-bathing [Odds Ratio (OR) = 5.65, 95% Confidence Intervals (CI): 2.3-14.4] and low level of education.

Conclusion: The results of this study demonstrate that acute hospitalization is frequent in AD patients resulting in considerable cost implications. Interventions that support patients and their cares to manage their loss of ADL may be a practical approach to reducing the need for acute hospital admissions.