Dementia patients have poor outcomes in hospital

If you have dementia and need to be admitted to hospital to be treated for other illnesses or injuries, your prospects for recovery are substantially worse than for other patients, research has found.

Conjoint Professor Brian Draper, from the School of Psychiatry at the University of New South Wales, will tell the National Dementia Research Forum in Sydney today that patients with dementia have worse outcomes of hospital care than patients without dementia.

These include higher mortality rates, longer admissions and increased risk of transfer to a nursing home. The findings are based on a study of over 20,000 people with dementia admitted to NSW public hospitals in 2006/07.

People with dementia have over double the risk of hip fractures and head injuries and are susceptible to a range of other illnesses including chest and urinary infections, frequently requiring them to be admitted to hospitals. However, they then have substantially worse outcomes compared to patients without dementia.

Professor Draper said the admission to hospital can mark a “line in the sand” from which dementia patients may never fully recover.

“Being in a strange hospital environment can increase confusion and some may be better off treated in their own home provided there are adequate medical, allied health and nursing services to support them and their carers,” he said. “Advanced care planning to avoid unnecessary hospital admissions for people with dementia living in residential aged care facilities is an important initiative that can help this.”

Hospitals worldwide have not been well-designed for dementia or have adequate numbers of well trained staffed to look after confused older people with dementia. “It’s a lack of numbers and it’s a lack of skills,” he said.

Dementia is a growing problem, with an expected one million Australians and 113 million people worldwide forecast to be diagnosed with the illness by 2050.

Conference convener Professor Henry Brodaty and Glen Rees, CEO of Alzheimer's Australia this week co-wrote an opinion piece in The Age newspaper calling for a lift in government funding for Alzheimer’s research to solve treatment gaps and better educate health care professionals.

Professor Draper is a chief investigator on the Hospital Dementia Services Project, which examined data from over 200 hospitals in NSW. The study is a collaboration between UNSW, the University of Canberra and the Australian Institute of Health and Welfare, and is funded by the National Health and Medical Research Council.