ASSOCIATION OF BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA WITH ADVERSE OUTCOMES POSTHOSPITALIZATION

Abstract

Abstract In hospitalized persons with dementia, behavioral and psychological symptoms of dementia (BPSD), also known as behavioral symptoms of distress, are associated with increased morbidity, long-term care admissions, and reduced care partner well-being. The Fam-FFC study provided the opportunity to examine the association between BPSD severity and adverse, post-acute outcomes (falls, emergency department transfers, hospital admissions). Logistic regression analysis examined the association of behavioral symptoms (Neuropsychiatric Inventory Questionnaire, NPI) and odds of having a fall, emergency department transfer, and hospital admission, controlling for the intervention, and caregiver and patient characteristics. NPI scores decreased from admission (M = 7.81, SD = 6.12), to discharge (M = 6.4, SD = 5.93), to two months (M = 5.38, SD = 5.91), to six-month follow-up (M = 5.08, SD = 5.94). Higher admission NPI scores were associated with greater odds of experiencing at least one fall (OR = 1.067, p = 0.042) by discharge. Higher discharge NPI scores were associated with higher odds of ED transfer (OR = 1.062, p = 0.006) and at least one hospitalization (OR = 1.06, p = 0.008) after two months. Higher NPI scores at 2-month follow-up were associated with increased odds of ED transfer (OR = 1.062, p = 0.004), experiencing at least one injury (OR = 1.055, p = 0.031), falls (OR = 1.056, p = 0.012), and hospitalizations (OR = 1.065, p = 0.004) at six months. Results underscore the importance of providing interventions to reduce BPSD as a potentially modifiable risk factor to reduce adverse outcomes.