Association of Living Alone and Hospitalization Among Community-Dwelling Elders With and Without Dementia

Journal of General Internal Medicine

Volumn 29, Issue 11, 2014, Pages 1451-1459

  Ennis, Stephanie K ^a   Larson, Eric B ^a,c   Grothaus, Louis ^c   Helfrich, Christian D ^a,d   Balch, Steven ^c   Phelan, Elizabeth A ^a,b,c  

^a UNIVERSITY OF WASHINGTON   (United States)

^b UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

^c GROUP HEALTH RESEARCH INSTITUTE   (United States)

^d VA Puget Sound Health Services Research and Development   (United States)

Author keywords

aging; ambulatory care; dementia; health care delivery; social support

Indexed keywords

AGED; DEMENTIA; DEMOGRAPHY; FEMALE; FOLLOW UP; HOSPITALIZATION; HUMAN; MALE; RETROSPECTIVE STUDY; RISK FACTOR; SOCIOECONOMICS; STATISTICS AND NUMERICAL DATA; UNITED STATES; VERY ELDERLY;

AGED; AGED, 80 AND OVER; DEMENTIA; FEMALE; FOLLOW-UP STUDIES; HOSPITALIZATION; HUMANS; MALE; RESIDENCE CHARACTERISTICS; RETROSPECTIVE STUDIES; RISK FACTORS; SOCIOECONOMIC FACTORS; UNITED STATES;

EID: 84930921533     PISSN: 08848734     EISSN: 15251497     Source Type: Journal    
DOI: 10.1007/s11606-014-2904-z     Document Type: Article

References (64)

1. DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A. 2006 National Hospital Discharge Survey. US Centers for Disease Control and Prevention National Health Statistics Reports. 2008;5:1–20.
2. US Centers for Disease Control and Prevention National Hospital Discharge Survey. Atlanta: Centers for Disease Control and Prevention; Data highlights- selected tables; number and rate of discharges by sex and age; 2012 Aug 28. Available from: http://www.cdc.gov/nchs/nhds/nhds_products.htm. Accessed April 16, 2014.
3. Jiang HJ, Wier LM, Potter D, Burgess J. Potentially Preventable Hospitalizations among Medicare-Medicaid Dual Eligibles, 2008: Statistical Brief #96. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Health Care Policy and Research (US); 2006. Available at: http://www.ncbi.nlm.nih.gov/books/NBK52652/. Accessed April 16, 2014.
4. Pfuntner A, Wier LM, Stocks C. Most Frequent Conditions in U.S. Hospitals, 2010: Statistical Brief #148. 2006. Available at: http://www.ncbi.nlm.nih.gov/books/NBK127490/. Accessed April 16, 2014.
5. Phelan EA, Borson S, Grothaus L, Balch S, Larson EB. Association of incident dementia with hospitalizations. JAMA. 2012;307(2):165–172.
6. Bindman AB, Grumbach K, Osmond D, et al. Preventable hospitalizations and access to health care. JAMA. 1995;274(4):305–311.
7. Billings J, Zeitel L, Lukomnik J, Carey TS, Blank AE, Newman L. Impact of socioeconomic status on hospital use in New York City. Health Aff (Millwood). 1993;12(1):162–173.
8. Ingold BB, Yersin B, Wietlisbach V, Burckhardt P, Bumand B, Büla CJ. Characteristics associated with inappropriate hospital use in elderly patients admitted to a general internal medicine service. Aging (Milano). 2000;12(6):430–438.
9. Murphy BM, Elliott PC, Le Grande MR, et al. Living alone predicts 30-day hospital readmission after coronary artery bypass graft surgery. Eur J Cardiovasc Prev Rehabil. 2008;15(2):210–215.
10. Di Iorio A, Longo AL, Mitidieri Costanza A, et al. Characteristics of geriatric patients related to early and late readmissions to hospital. Aging (Milano). 1998;10(4):339–346.
11. Lett HS, Blumenthal JA, Babyak MA, Strauman TJ, Robins C, Sherwood A. Social support and coronary heart disease: epidemiologic evidence and implications for treatment. Psychosom Med. 2005;67(6):869–878.
12. Schmaltz HN, Southern D, Ghali WA, et al. Living alone, patient sex and mortality after acute myocardial infarction. J Gen Intern Med. 2007;22(5):572–578.
13. Tennstedt SL, Crawford S, McKinlay JB. Determining the pattern of community care: is coresidence more important than caregiver relationship? J Gerontol. 1993;48(2):S74–83.
14. Chappell NL. Living arrangements and sources of caregiving. J Gerontol. 1991;46(1):S1–8.
15. Lund R, Due P, Modvig J, Holstein BE, Damsgaard MT, Andersen PK. Cohabitation and marital status as predictors of mortality–an eight year follow-up study. Soc Sci Med. 2002;55(4):673–679.
16. DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol. 2004;23(2):207–218.
17. Haslbeck JW, McCorkle R, Schaeffer D. Chronic illness self-management while living alone in later life: a systematic integrative review. Research on Aging. 2012;34(5):507–547.
18. Carmel S, Anson O, Levin M. Emergency department utilization: a comparative analysis of older-adults, old and old-old patients. Aging (Milano). 1990;2(4):387–393.
19. Albert SM, Costa R, Merchant C, Small S, Jenders RA, Stern Y. Hospitalization and Alzheimer’s disease: results from a community-based study. J Gerontol A Biol Sci Med Sci. 1999;54(5):M267–271.
20. Bynum JPW, Rabins PV, Weller W, Niefeld M, Anderson GF, Wu AW. The relationship between a dementia diagnosis, chronic illness, Medicare expenditures, and hospital use. J Am Geriatr Soc. 2004;52(2):187–194.
21. Zhao Y, Kuo T-C, Weir S, Kramer MS, Ash AS. Healthcare costs and utilization for Medicare beneficiaries with Alzheimer’s. BMC Health Serv Res. 2008;8:108.
22. Natalwala A, Potluri R, Uppal H, Heun R. Reasons for hospital admissions in dementia patients in Birmingham, UK, during 2002–2007. Dement Geriatr Cogn Disord. 2008;26(6):499–505.
23. Nourhashemi F, Amouyal-Barkate K, Gillette-Guyonnet S, Cantet C, Vellas B. Living alone with Alzheimer’s disease: cross-sectional and longitudinal analysis in the REAL.FR Study. J Nutr Health Aging. 2005;9(2):117–120.
24. Miranda-Castillo C, Woods B, Orrell M. People with dementia living alone: what are their needs and what kind of support are they receiving? Int Psychogeriatr. 2010;22(4):607–617.
25. Tierney MC, Snow WG, Charles J, Moineddin R, Kiss A. Neuropsychological predictors of self-neglect in cognitively impaired older people who live alone. Am J Geriatr Psychiatry. 2007;15(2):140–148.
26. Tierney MC, Charles J, Naglie G, Jaglal S, Kiss A, Fisher RH. Risk factors for harm in cognitively impaired seniors who live alone: a prospective study. J Am Geriatr Soc. 2004;52(9):1435–1441.
27. Larson EB, Kukull WA, Teri L, et al. University of Washington Alzheimer’s Disease Patient Registry (ADPR): 1987–1988. Aging (Milano). 1990;2(4):404–408.
28. Kukull WA, Higdon R, Bowen JD, et al. Dementia and Alzheimer disease incidence: a prospective cohort study. Arch Neurol. 2002;59(11):1737–1746.
29. Saunders KW, Davis RL, Stergachis A. Group Health Cooperative. In: Pharmacoepidemiology. 4th ed. Hoboken: Wiley; 2005:223–240.
30. Culler SD, Parchman ML, Przybylski M. Factors related to potentially preventable hospitalizations among the elderly. Med Care. 1998;36(6):804–817.
31. McCall N, Harlow J, Dayhoff D. Rates of hospitalization for ambulatory care sensitive conditions in the Medicare + Choice population. Health Care Financ R. 2001;22(3):127–146.
32. Teng EL, Hasegawa K, Homma A, et al. The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Int Psychogeriatr. 1994;6(1):45–58.
33. Jorm AF, Korten AE. Assessment of cognitive decline in the elderly by informant interview. Br J Psychiatry. 1988;152:209–213.
34. Folstein MF, Folstein SE, McHugh PR. Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198.
35. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34(7):939–944.
36. Davis MA, Neuhaus JM, Moritz DJ, Segal MR. Living arrangements and survival among middle-aged and older adults in the NHANES I epidemiologic follow-up study. Am J Public Health. 1992;82(3):401–406.
37. Kasper J. Aging alone: profiles and projections, a report of the Commonwealth Fund Commission on Elderly People Living Alone. Washington: Commonwealth Fund; 1988.
38. Klinenberg, E, Torres, S, Portacolone, E. Aging alone in America: a briefing paper prepared for the Council on Contemporary Families for Older Americans month May 2012. 2012. Available at: http://www.contemporaryfamilies.org/wp-content/uploads/2013/10/2012_Briefing_Klinenberg_Aging-alone-in-america.pdf. Accessed April 16, 2014.
39. Walker AE. Multiple chronic diseases and quality of life: patterns emerging from a large national sample, Australia. Chronic Illn. 2007;3(3):202–218.
40. Magaziner J, Cadigan DA, Hebel JR, Parry RE. Health and living arrangements among older women: does living alone increase the risk of illness? J Gerontol. 1988;43(5):M127–133.
41. Worobey JL, Angel RJ. Functional capacity and living arrangements of unmarried elderly persons. J Gerontol. 1990;45(3):S95–101.
42. Putnam KG, Buist DSM, Fishman P, et al. Chronic disease score as a predictor of hospitalization. Epidemiology. 2002;13(3):340–346.
43. Landi F, Onder G, Cesari M, et al. Comorbidity and social factors predicted hospitalization in frail elderly patients. J Clin Epidemiol. 2004;57(8):832–836.
44. Inouye SK, Zhang Y, Jones RN, et al. Risk factors for hospitalization among community-dwelling primary care older patients: development and validation of a predictive model. Med Care. 2008;46(7):726–731.
45. Jacobs JM, Rottenberg Y, Cohen A, Stessman J. Physical activity and health service utilization among older people. J Am Med Dir Assoc. 2013;14(2):125–129. doi:10.1016/j.jamda.2012.10.023.
46. Fishman PA, Goodman MJ, Hornbrook MC, Meenan RT, Bachman DJ, O’Keeffe Rosetti MC. Risk adjustment using automated ambulatory pharmacy data: the RxRisk model. Med Care. 2003;41(1):84–99.
47. Sloan KL, Sales AE, Liu C-F, et al. Construction and characteristics of the RxRisk-V: a VA-adapted pharmacy-based case-mix instrument. Med Care. 2003;41(6):761–774. doi:10.1097/01.MLR.0000064641.84967.B7.
48. Huntley AL, Johnson R, Purdy S, Valderas JM, Salisbury C. Measures of Multimorbidity and Morbidity Burden for Use in Primary Care and Community Settings: A Systematic Review and Guide. Ann Fam Med. 2012;10(2):134–141. doi:10.1370/afm.1363.
49. Wang L, Larson EB, Bowen JD, van Belle G. Performance-based physical function and future dementia in older people. Arch Intern Med. 2006;166(10):1115–1120.
50. Cohen S, Mermelstein R, Kamarck T, Hoberman H. Measuring the functional components of social support. In: Sarason IG, Sarason BR, eds. Social support: Theory, research, and application. The Hague, Holland: Martinus Nijhoff; 1985.
51. Martire LM, Schulz R, Mittelmark MB, Newsom JT. Stability and change in older adults’ social contact and social support: the Cardiovascular Health Study. J Gerontol B Psychol Sci Soc Sci. 1999;54(5):S302–311.
52. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84.
53. Ferrer A, Badia T, Formiga F, et al. Frailty in the oldest old: prevalence and associated factors. J Am Geriatr Soc. 2013;61(2):294–296.
54. Balardy L, Voisin T, Cantet C, Vellas B. Predictive factors of emergency hospitalisation in Alzheimer’s patients: results of one-year follow-up in the REAL.FR Cohort. J Nutr Health Aging. 2005;9(2):112–116.
55. Caspi E, Silverstein NM, Porell F, Kwan N. Physician outpatient contacts and hospitalizations among cognitively impaired elderly. Alzheimers Dement. 2009;5(1):30–42.
56. Boult C, Dowd B, McCaffrey D, Boult L, Hernandez R, Krulewitch H. Screening elders for risk of hospital admission. J Am Geriatr Soc. 1993;41(8):811–817.
57. Billings J, Dixon J, Mijanovich T, Wennberg D. Case finding for patients at risk of readmission to hospital: development of algorithm to identify high risk patients. BMJ. 2006;333(7563):327. doi:10.1136/bmj.38870.657917.AE.
58. Billings J, Blunt I, Steventon A, Georghiou T, Lewis G, Bardsley M. Development of a predictive model to identify inpatients at risk of re-admission within 30 days of discharge (PARR-30). BMJ Open. 2012;2(4). doi:10.1136/bmjopen-2012-001667
59. Bottle A, Aylin P, Majeed A. Identifying patients at high risk of emergency hospital admissions: a logistic regression analysis. J R Soc Med. 2006;99(8):406–414. doi:10.1258/jrsm.99.8.406.
60. Howell S, Coory M, Martin J, Duckett S. Using routine inpatient data to identify patients at risk of hospital readmission. BMC Health Serv Res. 2009;9:96. doi:10.1186/1472-6963-9-96.
61. Michael YL, Berkman LF, Colditz GA, Kawachi I. Living arrangements, social integration, and change in functional health status. Am J Epidemiol. 2001;153(2):123–131.
62. Nihtilä E, Martikainen P. Why older people living with a spouse are less likely to be institutionalized: the role of socioeconomic factors and health characteristics. Scand J Public Health. 2008;36(1):35–43.
63. Manton KG. Recent declines in chronic disability in the elderly U.S. population: risk factors and future dynamics. Annu Rev Public Health. 2008;29:91–113.
64. Aging In Place: A State Survey of Livability Policies and Practices - AARP. AARP. Available at: http://www.aarp.org/home-garden/livable-communities/info-11-2011/Aging-In-Place.html. Accessed April 16, 2014.