Abstract Details

Title Regional and Demographics Difference in the Impact of High Ambient Temperature Exposure on Alzheimer’s Disease and Related Dementias Hospitalization in Medicare Beneficiaries

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-001

Objective To investigate the regional impact of local heat stress on Alzheimer’s disease and related dementias (ADRD)

Background ADRD is a leading cause of hospitalization among older adults and disease severity may be exacerbated by environmental stressors, including extreme temperature.

Design/Methods Using a time-stratified case-crossover design, we identified beneficiaries in 2018 Medicare claims data who were hospitalized due to ADRD, defined as an ICD-10 diagnosis code in the first 10 positions on the claim, from April-October. We classified the case day as the ADRD admission date and controls days were matched on the same year, month, and day of the week. We used the latitude and longitude of the beneficiaries’ residential zip+4 to link the 2018 average daily temperature obtained from the National Oceanic and Atmospheric Administration. Temperature exposure was classified using location-specific percentiles, with the 50th percentile representing typical temperatures. We used a distributed lag nonlinear model within conditional logistic regression framework to assess the association between temperature and ADRD hospitalizations.

Results We identified 101,917 case days and 349,359 matched control days. Across the United States, relative to the 50th percentile, exposure to extreme heat (99th percentile) was associated with an increased odds of ADRD hospitalization two days later (OR=1.12 [95% CI: 1.06–1.18]). The impact of heat was greater among beneficiaries aged 81 years and older (OR=1.22 [95% CI: 1.12-1.32]), white (OR=1.12 [95% CI: 1.06-1.19]), and dual Medicare and Medicaid (OR=1.24 [95% CI: 1.14-1.36]). Regional analysis indicated highest heat-related ADRD hospital admissions occurred in the South (OR=1.11 [95% CI: 1.01-1.20]).

Conclusions Heat exposure was associated with a higher odds of ADRD hospital admission two days following, with the greatest impact on those >85 and those living in the South. This study may inform efforts to mitigate heat-related morbidity in individuals living with ADRD amid rising global temperatures.

Authors/Disclosures
George K. Karway, PhD (Barrow Neurological Institute) PRESENTER	Dr. Karway has nothing to disclose.
Jordan A. Killion, PhD (Barrow Neurological Institute)	Dr. Killion has received personal compensation for serving as an employee of CommonSpirit Health. The institution of Dr. Killion has received research support from The Michael J. Fox Foundation for Parkinson's Research (MJFF-000939). The institution of Dr. Killion has received research support from Department of Defense Grant (PD190057). The institution of Dr. Killion has received research support from Barrow Neurological Foundation. The institution of Dr. Killion has received research support from Kemper and Ethel Marley Foundation. The institution of Dr. Killion has received research support from Moreno Family.
Brittany Krzyzanowski, PhD	Dr. Krzyzanowski has nothing to disclose.
Brad A. Racette, MD, FAAN (Barrow Neurological Institute)	Dr. Racette has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for American Regent. Dr. Racette has received personal compensation in the range of $500-$4,999 for serving as a advisory council with NIEHS.

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