Objectives: To conduct a systematic review and meta-analysis of the literature of the factors leading to hospital admission for people with dementia in comparison with (1) people without dementia acutely admitted and (2) people with dementia in the community.
Results: Inpatients with dementia are at an increased risk of crisis owing to physical health-related factors, including orthopedic, respiratory, and urologic, than inpatients who do not have dementia. We also reviewed data that compared people with dementia admitted with those who were not and found that behavioral problems, such as agitation and wandering, placed people with dementia at an increased risk of being admitted. Interestingly, we also found that changes in routine and environment and increased dependency problems in several activities of daily living were associated with a higher risk of hospitalization for people with dementia.
Conclusions: Many older people's crisis teams tend to focus on prevention and reducing psychiatric admissions. This review highlights the need for recognition of the physical health risks in these patients and a low threshold for early treatment in the community. This review highlights the importance of integrated working between services for older people's mental health, primary care, social welfare, intermediate care, and hospital liaison.
Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.