TY - JOUR
T1 - Delirium superimposed on dementia in a community-dwelling managed care population
T2 - A 3-year retrospective study of occurrence, costs, and utilization
AU - Fick, Donna M.
AU - Kolanowski, Ann M.
AU - Waller, Jennifer L.
AU - Inouye, Sharon K.
N1 - Funding Information:
ACKNOWLEDGMENTS This work was supported in part by a grant from Blue Cross Blue Shield of Georgia and the Center for Healthcare Improvement. Dr. Fick is also a recipient of a Birmingham/Atlanta GRECC, VISN-7 GEC pilot grant program award. Dr. Inouye is supported by Midcareer Award K24 AG00949 and Research Grant RO1AG12551 from the National Institute on Aging and Donaghue Investigator Award DF98-105 from the Patrick and Catherine Weldon Donaghue Medical Research Foundation.
PY - 2005/6
Y1 - 2005/6
N2 - Background. Dementia is a growing public health problem and a well-described risk factor for delirium. Yet little is known about delirium superimposed on dementia in community-dwelling populations. The purpose of this study was to examine the 3-year occurrence, healthcare utilization, and costs associated with delirium superimposed on dementia in community-dwelling persons. Methods. We used a 3-year cross-sectional, retrospective design with an administrative database from a large managed care organization. Four individually matched samples of 699 individuals each were selected for comparison purposes: delirium superimposed on dementia (DSD), dementia alone, delirium alone, and a control group with neither delirium nor dementia. The occurrence rate of DSD was calculated by measuring those individuals with a dementia diagnosis that were also coded with an International Classification of Diseases, Ninth Edition Clinical Modification (ICD-9 CM) code for delirium or delirium with dementia. Results. Of the total sample of 76,688 persons aged 65 years or older in the managed care organization, 7347 (10%) were coded as having dementia, and an additional 763 (1%) as having delirium alone. Among the 7347 with dementia, 976 (13%) had DSD, representing 1.3% of the total sample. After log transformation of total costs and adjustment for multiple covariates, the adjusted mean total health care costs remained significantly higher for the DSD group than for all other groups. Conclusions. This study is the first to report the occurrence rate of DSD in a community-dwelling population, and to demonstrate the substantial health care costs and utilization associated with DSD.
AB - Background. Dementia is a growing public health problem and a well-described risk factor for delirium. Yet little is known about delirium superimposed on dementia in community-dwelling populations. The purpose of this study was to examine the 3-year occurrence, healthcare utilization, and costs associated with delirium superimposed on dementia in community-dwelling persons. Methods. We used a 3-year cross-sectional, retrospective design with an administrative database from a large managed care organization. Four individually matched samples of 699 individuals each were selected for comparison purposes: delirium superimposed on dementia (DSD), dementia alone, delirium alone, and a control group with neither delirium nor dementia. The occurrence rate of DSD was calculated by measuring those individuals with a dementia diagnosis that were also coded with an International Classification of Diseases, Ninth Edition Clinical Modification (ICD-9 CM) code for delirium or delirium with dementia. Results. Of the total sample of 76,688 persons aged 65 years or older in the managed care organization, 7347 (10%) were coded as having dementia, and an additional 763 (1%) as having delirium alone. Among the 7347 with dementia, 976 (13%) had DSD, representing 1.3% of the total sample. After log transformation of total costs and adjustment for multiple covariates, the adjusted mean total health care costs remained significantly higher for the DSD group than for all other groups. Conclusions. This study is the first to report the occurrence rate of DSD in a community-dwelling population, and to demonstrate the substantial health care costs and utilization associated with DSD.
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U2 - 10.1093/gerona/60.6.748
DO - 10.1093/gerona/60.6.748
M3 - Article
C2 - 15983178
AN - SCOPUS:21144440608
SN - 1079-5006
VL - 60
SP - 748
EP - 753
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 6
ER -