Physician outpatient contacts and hospitalizations among cognitively impaired elderly.

TitlePhysician outpatient contacts and hospitalizations among cognitively impaired elderly.
Publication TypeJournal Article
Year of Publication2009
AuthorsCaspi, E, Silverstein, NM, Porell, F, Kwan, N
JournalAlzheimers Dement
Date Published2009 Jan
ISSN Number1552-5279
Call Numbernewpubs20090908/article.pdf
KeywordsAged, Aged, 80 and over, Alzheimer disease, Ambulatory Care, Cognition Disorders, Community-Institutional Relations, Comorbidity, Female, Hospitalization, Housing for the Elderly, Humans, Male, Memory Disorders, Physicians, Prevalence, Severity of Illness Index

BACKGROUND: This study examined how physician contacts and hospitalizations vary in relation to cognitive function level among community-residing older adults.

METHODS: Analysis of the 1998 wave of the Health and Retirement Survey (HRS) was conducted to create three levels of cognitive function among 6,991 older adults by using direct measures for self-respondents and proxy evaluations. Ordinary least square regression analyses were used to estimate the probability of physician outpatient contacts, number of hospitalizations, and nights hospitalized during the last 2 years.

RESULTS: Lower cognitive function level was found to be associated with decreasing levels of physician contacts and increasing levels of hospitalizations as well as nights hospitalized. In addition, lower cognitive function levels were consistently related to a variety of comorbidities. Moreover, many older adults with low cognitive function levels reported or were reported by their proxies as not having a diagnosis of a memory-related disease (MRD). Finally, having a diagnosis of an MRD was found to be associated with more physician contacts but fewer hospital nights compared with those who had never received such a diagnosis.

CONCLUSIONS: The findings suggest the need for increased outreach targeted at identification of community-dwelling older adults with decline in cognitive function who are in need of care but are underdiagnosed, underutilize physician care, and are overhospitalized.

User Guide Notes

Endnote Keywords

Cognitive Functioning/Health Care Utilization

Endnote ID


Alternate JournalAlzheimers Dement
Citation Key7323
PubMed ID19118807