Does dementia influence the trajectories of the duration of hospitalizations at the last year of life?

• Grant number: 24/02843-0
• Support Opportunities: Scholarships abroad - Research Internship - Master's degree
• Start date: December 01, 2024
• End date: May 31, 2025
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Tiago da Silva Alexandre
• Grantee: Thaís Barros Pereira da Silva
• Supervisor: Cesar Messias de Oliveira
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Institution abroad: University College London (UCL), England
• Associated to the scholarship: 23/09037-6 - Factors associated with hospital outcomes in people with dementia in their last years of life, BP.MS

Abstract

Despite the diagnosis of dementia providing a longer survival in advanced stages, this condition is associated with an increased prevalence of potentially avoidable hospitalization episodes. As the end-of-life period approaches, such episodes tend to take on more complex characteristics, becoming more frequent and prolonged. However, there are limited longitudinal evidence that have explored how the diagnosis of dementia affects hospitalization patterns in the final years of life. The aim of this proposal is to analyze whether the trajectories of hospital episode duration is worse in individuals diagnosed with dementia at the end of life compared to those without this diagnosis. Data from the English Longitudinal Study of Ageing (ELSA) linked to the Hospital Episode Statistics (HES) will be utilized. The changes in the duration of the hospitalization period over time will be presented continuously, in days, and will be calculated based on the difference between the discharge and admission dates for each hospital episode occurring in the last year of life. The diagnosis of dementia will be verified by the presence of ICD-10 (International Statistical Classification of Diseases and Related Health Problems) codes "F00" (Dementia in Alzheimer disease), "F01" (Vascular dementia), "F02" (Dementia in other diseases classified elsewhere), "F03" (Unspecified dementia), and "G30" (Alzheimer's disease). For the analysis of hospitalization episode duration trajectories, growth curve modelling (GCM) will be employed, controlled for sociodemographic, behavioral, clinical, and healthcare service-related variables. The present project aims to contribute to the effective promotion of quality care in the end-of-life period, so that current healthcare models develop new strategies to prevent the increase in the incidence of avoidable hospitalization episodes.