Diagnostic Correlates of Alzheimer Dementia in a U.S. Nationwide Inpatient Sample

ArticleinThe American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 18(9):821-9 · September 2010with5 Reads
Impact Factor: 4.24 · DOI: 10.1097/JGP.0b013e3181ca3a13 · Source: PubMed


    Alzheimer dementia (ALZ-D) is among the most frequent diseases in the elderly. Several somatic and psychiatric disorders have been suggested to be related to this diagnosis. The aim of this analysis of a large and representative U.S. nationwide inpatient sample (NIS) was to identify diagnostic correlates of ALZ-D in subjects aged 60 years and older.
    Of the total sample of 800,457 inpatient subjects ( approximately 2% of all inpatients in 2004), 315,244 individuals were 60 years or older. Of these, 9,572 (3.03%) received a diagnosis of ALZ-D, whereas 33,367 (10.59%) were diagnosed with osteoarthritis (OA) and served as a comparison group. Comparisons of potential somatic and psychiatric diagnostic correlates were conducted.
    As determined by both univariate comparison and multivariate logistic regression analysis, after controlling for age and gender, subjects with ALZ-D (versus OA) had an overall higher rate of diagnoses of diseases of the vascular system (stroke: odds ratio 1.69; 95% confidence interval: 1.25-2.30) and psychotic and affective disorders (bipolar: 2.78 [1.26-6.12]; schizoaffective: 3.06 [2.10-4.47]). Increasing age and male gender were positively associated with the diagnosis of ALZ-D.
    Many somatic diagnoses related to ALZ-D were confirmed by these analyses of the NIS. However, psychotic and affective disorders were identified to be equally significant correlates of ALZ-D, even in the presence of all other disorders. Prospective and longitudinal data are needed to investigate potential causal and temporal relationships between ALZ-D with somatic and psychiatric disorders.