Distress Associated with Dementia-Related Psychosis and Agitation in Relation to Healthcare Utilization and Costs
Section snippets
Data Sources
The ADAMS sample was drawn from the larger Health and Retirement Study, an ongoing, nationally representative cohort of individuals aged over 50 years that began in 1992. ADAMS was designed to provide nationally representative data on the antecedents, prevalence, outcomes, and costs of dementia and began with a stratified random subsample of 1,770 individuals selected from HRS respondents older than 70 years who completed the 2000 or 2002 HRS wave.19 Of those HRS respondents selected for
Results
Characteristics of ADAMS participants with dementia are presented in Table 1. In the sample, 58 participants (15.0%) had significant BPSD (hereafter, “significant BPSD” will refer specifically to presence of clinically significant symptoms in the NPI domains of psychosis [delusions and/or hallucinations] or agitation). Overall, this group had more impaired cognition and more severe dementia than the group without significant BPSD. The group with significant BPSD had a higher total NPI score
Conclusions
Using the only nationally representative sample of patients with dementia in the U.S., which we have linked with Medicare claims, our main finding is that informant distress related to psychosis or agitation in persons with dementia is associated with increased ED utilization, inpatient hospitalization, and Medicare expenditures. Contrary to our hypothesis, the NPS burden among ADAMS participants was not independently associated with utilization or cost in either unadjusted or adjusted models,
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