Abstract Details

Title Hospitalization Patterns and Risk Factors in Adults with Alzheimer's Disease and Related Dementias (ADRD) with and Without Epilepsy: A Multi-state Cohort Study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S41 - Epilepsy: Public Health and Epidemiology (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Objective

This study aims to identify and compare hospitalization patterns in patients with Alzheimer’s Disease and Related Dementias (ADRD) with and without epilepsy.

Background Current evidence points to a bi-directional relationship between epilepsy and ADRD, with both conditions increasing risks of hospitalization. However, comprehensive information on hospitalization patterns and risk factors in patients with co-morbid ADRD and epilepsy remains limited.

Design/Methods We analyzed Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) hospitalizations between 2016-2018 in four US states (New York, Wisconsin, Maryland, Florida) for patients aged > 65 years with ADRD (any hospitalization with an ADRD diagnosis code, n = 707,531) and ADRD+epilepsy (any hospitalization with an ADRD and epilepsy [G40] diagnosis codes, n = 43,209). We modeled inpatient hospitalization rates using negative binomial regression, adjusting for demographics, insurance status, income quartile, sex, state of residence, and Elixhauser co-morbidity index. We also examined length of stay (LOS) as a secondary outcome.

Results

Patients with ADRD+epilepsy demonstrated significantly higher hospitalization rates (rate ratio [RR] 1.10, 95% CI: 1.08-1.12), with more annual hospital visits (1.5 per year, versus 1.4 for ADRD alone, p < 0.0001). The ADRD+epilepsy group had a longer mean LOS (7.8 versus 6.6 days, p < 0.0001) compared with admissions in patients with ADRD alone. Racial disparities were striking, with Black patients representing 23.6% of the ADRD+epilepsy cohort versus 12.6% of ADRD alone (p < 0.0001). Black patients also experienced high rates of hospitalization (RR 1.24, 95% CI: 1.23-1.25) versus White patients. Hispanic/Latino patients (RR 1.22, 95% CI: 1.21-1.23) and Native American patients (RR 1.24, 95% CI: 1.09-1.41) also had increased hospitalization rates.

Conclusions Co-morbid epilepsy significantly increases inpatient hospitalization rates for those with ADRD, with especially pronounced disparities among racially minoritized groups. These findings underscore the need for targeted coordination of care and preventive interventions for higher risk ADRD patients with epilepsy.

Authors/Disclosures
Sanika Joshi, BS PRESENTER	Ms. Joshi has nothing to disclose.
Rose Rasty	Ms. Rasty has nothing to disclose.
Megan A. Hsu, BA	Ms. Hsu has nothing to disclose.
Marlon G. Coelho, MD (Newark Beth Israel)	Dr. Coelho has nothing to disclose.
Helen A. Clement, PhD	Dr. Clement has received personal compensation for serving as an employee of Xenon Pharmaceuticals. Dr. Clement has stock in Xenon Pharmaceuticals. Dr. Clement has received intellectual property interests from a discovery or technology relating to health care.
Kylie Getz	Kylie Getz has nothing to disclose.
Brad K. Kamitaki, MD (Rutgers-Robert Wood Johnson Medical School)	Dr. Kamitaki has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Brown and Brown Absence Services Group. The institution of Dr. Kamitaki has received research support from New Jersey Health Foundation. The institution of Dr. Kamitaki has received research support from National Institute on Aging.

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