Frailty Plays Distinct Role in Health Outcomes of Home Care Patients With Dementia

The impact of dementia on long-term care (LTC) admission and mortality rates was significantly affected by frailty status in a population-based study of older adults receiving home care services in Canada. The study appeared online in BMJ Open.

“Our findings support the notion that dementia and frailty, though related, represent distinct clinical considerations in our understanding of the potential impact of population ageing on healthcare utilisation and costs,” researchers wrote.

The retrospective study looked at associations between dementia and 1-year health outcomes among adults age 50 and older who received home care services for 60 days or longer. The study included 153,125 people: 27% had a dementia diagnosis, and 26% were categorized as frail.

Overall, clients with dementia were older and more likely to be frail (30% vs 24%) compared with clients without dementia, according to the study, but those with dementia had lower levels of multimorbidity.

When researchers adjusted for frailty, they found clients with dementia had a lower incidence of urgent hospitalizations and lower mortality rates. The incidence of long-term care admission, however, was higher among clients with dementia.

“In adjusted analyses accounting for relevant competing risks, the impact of dementia on LTC admission and mortality over 1 year was significantly modified by frailty status,” researchers reported. “Specifically, the higher incidence of LTC admission and lower mortality rate evident among those with (vs without) dementia, observed overall, was attenuated with increasing frailty.”

—Jolynn Tumolo

Reference

Maxwell CJ, Mondor L, Hogan DB, et al. Joint impact of dementia and frailty on healthcare utilisation and outcomes: a retrospective cohort study of long-stay home care recipients. BMJ Open. 2019 June 21;9(6):e029523.