Older adults with Alzheimer’s disease and related dementia are twice as likely to die within a month or during the year following discharge from an intensive care unit compared to patients discharged from the ICU who do not have ADRD, according to a study published July 1 in the American Journal of Critical Care.
The research shows that ADRD patients often experience an acute reduction in cognitive function after an ICU admission, study co-author Mary Lynn Davis-Ajami, PHD, RN, told Becker's. She recently left North Andover, Mass.-based Merrimack College's School of Nursing and Health Sciences and is transitioning to Michigan State University College of Nursing in East Lansing, where she will be a professor and associate dean of academic affairs.
The study compared patients with ADRD to those without it and found that people with dementia are 60 percent less likely to be discharged home. In this group, there was a 54 percent higher risk of dying in the same month as discharged and a 95 percent greater risk of dying within 12 months.
Patients with both Medicare and Medicaid showed a greater risk of dying in the same month of discharge and an even greater risk of dying within 12 months of discharge compared with non-dual eligible patients, Dr. Davis-Ajami said.
"Goals of care, the patient's disease burden and comorbidity status should all be considered when determining whether to admit, and where to admit the ADRD patient," she said, noting these patients "have a limited life expectancy, which can be further shortened after an ICU admission or other acute event."
Therefore, she added, the study's findings suggest the need to develop proactive strategies to decrease the likelihood of an ADRD patient being admitted to the ICU.
"Our research team hopes to further explore whether incorporating palliative care planning in the emergency department or during ICU hospitalization would reduce some of the burden associated with ADRD care," Dr. Davis-Ajami said.