Neurology: 250,000 people big data research: people with dementia-related mental illness, their risk of death and long-term care risk increase sharply

Dementia affects more than 7 million Americans and is often accompanied by psychosis.
This phenomenon is called dementia-related psychosis (DRP).
Depending on the type of dementia and the development of the disease, approximately 20%-70% of patients will develop DRP, which is usually characterized by delusions and hallucinations.

DRP can be severely disabled and has a profound impact on patients and their caregivers, often leading to hospitalization.
The treatment plan for DRP is not ideal, because antipsychotic drugs often aggravate symptoms and may themselves be related to adverse events.
Currently, estimates of the incidence of DRP have not been obtained from large-scale administrative databases, and the potential impact of DRP, such as its relationship with long-term inpatient care (LTC) and death, has not been studied.

In this way, James B.
Wetmore and others of the Hennepin Healthcare Research Institute in the United States used the nationwide Medicare medical insurance data set to discover patients with dementia and DRP, and conducted a review of dementia patients with and without DRP.
Sexual cohort study.

They explored the relationship between dementia-related psychosis (DRP) and death and the use of long-term care (LTC);

The main hypothesis is that DRP will be associated with an increased risk of death and LTC use in patients with dementia.

The main hypothesis is that DRP will be associated with an increased risk of death and LTC use in patients with dementia.
The main hypothesis is that DRP will be associated with an increased risk of death and LTC use in patients with dementia.

The main clinical outcomes are LTC (defined as continuous admission to a nursing home for >100 days) and death.
DRP patients and dementia patients without psychosis were directly matched by age, gender, race, number of comorbidities, and dementia index year.
Finally, the Cox proportional hazard regression model was used to evaluate the relationship between DRP and clinical outcomes.

They included 256,408 patients with dementia.
Within 2 years after dementia was diagnosed, 13.
9% of the patients had DRP, and 31.
9% of the patients had died.
The corresponding estimates after 5 years are 25.
5% and 64.
0%.

The average age of patients with DRP and those without DRP is not much different (83.
8±7.
9 years), 83.
1±8.
7 years.
Females (71.
0% vs 68.
3%) and whites (85.
7% vs 82.
0%) in DRP patients are slightly more likely.

Within 2 years of suffering from DRP, 16.
1% entered LTC and 52.
0% died; the corresponding proportions of patients without DRP were 8.
4% and 30.
0%, respectively.

In the matched cohort, DRP was associated with greater risk of LTC (hazard ratio [HR] 2.
36, 2.
29-2.
44) and death (HR 2.
06, 2.
02-2.
10).

This big data study of 250,000 people shows that the risk of death of people with dementia-related mental illness has more than doubled, and the risk of requiring long-term care has increased nearly 2.
5 times.

The risk of death for people with dementia-related psychosis more than doubled, and the risk of requiring long-term care increased nearly 2.
5 times.
The risk of death for people with dementia-related psychosis more than doubled, and the risk of requiring long-term care increased nearly 2.
5 times.

Because the global population of dementia is expected to grow to more than 130 million by 2050, understanding the potential impact of DRP will provide patients, medical service providers, public health communities, payers and other stakeholders with important information.

Original Source: neurology.

org/content/96/12/e1620" target="_blank" rel="noopener">Association of Dementia-Related Psychosis With Long-term Care Use and Death

neurology.
org/content/96/12/e1620" target="_blank" rel="noopener">Association of Dementia-Related Psychosis With Long-term Care Use and Death
neurology.
org/content/96/12/e1620" target="_blank" rel="noopener">James B.
Wetmore, Yi Peng, Heng Yan, Suying Li, Muna Irfan, Andrew Shim, Nicholas S.
Roetker, Victor Abler, Nazia Rashid, David T.
Gilbertson
neurology.
org/content/96/12/e1620" target="_blank" rel="noopener">Neurology Mar 2021, 96 (12) e1620 -e1631; DOI: 10.
1212 / WNL.
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