Excess Mortality Among Assisted Living Residents With Dementia During the COVID-19 Pandemic.
Excess Mortality Among Assisted Living Residents With Dementia During the COVID-19 Pandemic.
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DOI：
10.1016/j.jamda.2022.07.023
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发表时间：
2022-10
影响因子：
7.6
通讯作者：
Thomas, Kali S.
中科院分区：
文献类型：
--
作者：
Hua, Cassandra L.;Cornell, Portia Y.;Zimmerman, Sheryl;Carder, Paula;Thomas, Kali S.
评估患有阿尔茨海默病和相关痴呆症（ADRD）的辅助生活（AL）居民在COVID-19大流行的前几个月内是否比没有ADRD的居民经历了更高的超额全因死亡率，并比较ADRD居民中记忆保健与一般AL的超额全因死亡率。回顾性队列研究。两组AL居民参加了医疗保险收费服务，他们在2019年或2020日历年期间居住在9位数邮政编码对应的美国AL社区≥25张床位。通过将医疗保险索赔和生命统计数据联系起来，我们检查了每周超额全因死亡率，将2020年3月12日至2020年12月31日的死亡率与2019年1月1日至2020年3月11日的死亡率进行比较。我们调整了人口统计学，慢性疾病，AL社区规模和县固定效应。在2019年的286，350名居民和2020年在这些队列中确定的273，601名居民中，约有31%被诊断为ADRD。在所有AL居民中，疫情期间，二零二零年的每周超额死亡率整体为每100，000人49. 1人。与没有ADRD的居民相比，在大流行期间，ADRD居民每100，000人的死亡人数增加了33.4人。在患有ADRD的居民中，居住在记忆护理社区的居民与居住在普通AL的居民相比，死亡率没有统计学显著差异。患有ADRD的AL居民比没有ADRD的居民更容易在COVID-19期间死亡，这一发现与养老院等其他环境中报告的结果相似。此外，该研究提供了重要的新信息，即与一般AL中的ADRD居民相比，记忆护理社区中的ADRD居民可能没有COVID-19死亡率的差异风险，尽管先前的研究表明他们患有更晚期的痴呆症。
To evaluate whether assisted living (AL) residents with Alzheimer’s disease and related dementias (ADRD) experienced a greater rate of excess all-cause mortality during the first several months of the COVID-19 pandemic compared to residents without ADRD, and to compare excess all-cause mortality rates in memory care vs general AL among residents with ADRD. Retrospective cohort study. Two cohorts of AL residents enrolled in Medicare Fee-For-Service who resided in 9-digit ZIP codes corresponding to US AL communities of ≥25 beds during calendar year 2019 or 2020. By linking Medicare claims and Vital Statistics data, we examined the weekly excess all-cause mortality rate, comparing the rate from March 12, 2020, to December 31, 2020, to the rate from January 1, 2019, to March 11, 2020. We adjusted for demographics, chronic conditions, AL community size, and county fixed effects. Of the 286,350 residents in 2019 and the 273,601 in 2020 identified in these cohorts, approximately 31% had a diagnosis of ADRD. Among all AL residents, the excess weekly mortality rate in 2020 was 49.1 per 100,000 overall during the pandemic. Compared to residents without ADRD, residents with ADRD experienced 33.4 more excess deaths per 100,000 during the pandemic. Among residents with ADRD, those who resided in memory care communities did not experience a statistically significant different mortality rate than residents who lived in general AL. AL residents with ADRD were more vulnerable to mortality during COVID-19 than residents without ADRD, a finding similar to those reported in other settings such as nursing homes. Additionally, the study provides important new information that residents with ADRD in memory care communities may not have been at differential risk of COVID-19 mortality when compared to residents with ADRD in general AL, despite prior research suggesting they have more advanced dementia.
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影响因子：
9.3
作者：
Harrison, Stephanie L.;Buckley, Benjamin J. R.;Lane, Deirdre A.;Underhill, Paula;Lip, Gregory Y. H.
通讯作者：
Lip, Gregory Y. H.
影响因子：
39
作者：
Panagiotou, Orestis A.;Kosar, Cyrus M.;Mor, Vincent
通讯作者：
Mor, Vincent
影响因子：
4.5
作者：
Guo, Wenhan;Li, Yue;Temkin-Greener, Helena
通讯作者：
Temkin-Greener, Helena
DOI：
10.1002/alz.12513
发表时间：
2022-10
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
通讯作者：
--
影响因子：
6.3
作者：
Temkin-Greener, Helena;Guo, Wenhan;Li, Yue
通讯作者：
Li, Yue