O4-04-06: Hospitalized Alzheimer's disease or dementia in Canada

This study provides an overall picture of the burden of hospitalized Alzheimer's disease or dementia (AD) in Canada. The diagnosis of AD (ICD-10-CA codes G300–301, G308–301, F010–013, F018–019, and F03) were identified from 2007/08 to 2010/11 acute care hospital separations (Hospital Morbidity Database) in all Canadian jurisdictions. In-hospital case fatality and hospital separation rates were calculated. Further, the most common comorbid (secondary) diagnoses were identified for the hospital separations with AD as the most responsible diagnosis (MRDx). The reverse was also examined. When AD was found as a comorbid (secondary) condition, the frequency of the MRDx was also quantified. Over the last four years, the number of hospitalizations with AD as MRDx increased from 12,484 in 2007/08 to 13,789 in 2010/11, the proportion of all hospitalization for each year remained stable (0.4%). There were more females than males (59% vs. 41%) for all four years. In 2010/11, on average, each AD hospitalization has 7.1 comorbid conditions, such as hypertension, diabetes, atrial fibrillation, hypothyroidism, and ischemic heart disease. Moreover, AD contributed to an additional 68,866 (males: 38.6%; females: 61.4%) hospital separations as a comorbid condition. Primarily, they were pneumonia, heart failure, COPD, and stroke. The average length of stay in hospital for AD was 46 days, compared to 7.1 days for hospitalizations for all causes in Canada. Only 20.2% (males: 19.2%; females: 21.0%) of AD patients were discharged home after their hospitalization. The in-hospital case fatality rate was 9.3% (males: 11.5%; females: 7.8%). Nearly half of AD patients (48.5%; males: 47.0%; females: 49.5%) were transferred to a long-term care facility. One fifth of the patients (18.3%) were transferred to home with support services. Although the proportion of AD hospitalization remained stable, the number of AD hospitalizations has increased over the last four years. AD has a high in-hospital case fatality rate, particularly among males. The long hospital stay, multiple comorbid conditions, and high rate of transfer to a long term care facility for AD indicate that it places a significant burden per case on the health care system in Canada.