AbstractPoster presentation: Sunday posterP1-430: Factors associated with ED visit and hospitalization among Alzheimer’s disease patients and their caregivers

The annual societal cost of Alzheimer's Disease (AD) exceeds $100 billion. Hospitalization and emergency department (ED) visits are a major source of these high health care expenditures. To identify the factors that lead to ED visits and hospitalizations among patients with AD and their CGs. Cross–sectional study of 153 patients with confirmed AD diagnosis and their CGs attending 10 primary care clinics in Indianapolis. Mean patients' age 77.7 (SD 5.8), 43% female, and 59% African American. Mean CGs' age 60.9 (SD 15), 89% female, 44% were patients’ spouse, and 69% were living with patients. Main outcome was the proportion of AD patients and the proportion of their CGs with ED visit or hospitalization in the past 6 months. 80% of the patients had MMSE <24, 75% were dependent in two IADLs, and 80% had at least one behavioral and psychological symptom. 38% of patients and 24% of their CG had at least one ED visit or hospitalization in the prior 6 months. For patients with AD and using multivariate logistic regression model, we found that the Cornell depression score (OR 1.09, 95% CI 1.02–1.17), the comorbidity disease score (OR 1.13, 95% CI 1.02–1.24), and having spouse as CG (OR 0.26, 95% CI 0.08–0.84) were associated with patients' ED visits and hospitalization. For CGs and using multivariate logistic regression model, we found that the patients' Neuropsychiatric Inventory (NPI) score was the only factor associated with the CG ED visit and hospital admission. (For each NPI point increase the OR was 1.03 with 95% CI 1.01–1.06). Behavioral and psychological symptoms related to AD associate with not only patients' higher health care utilization but with their caregivers' use also. Management of these symptoms in primary care system might lead to significant decrease in AD related burden.