Prevalence,Risk Factors And Economic Burden Of Dementia In Hospitalized Patients

Part one Prevalence of dementia in hospitalized patientsObjective: To investigate the prevalence of dementia and the major types of dementia in hospitalized patients.Methods: 1232 elderly patients who were hospitalized in the Department of Neurology of Hebei General Hospital from December 2016 to December 2017 were selected to record the patients' age,sex,marital status,education years and other general conditions,and the Mini-Mental State Examination(MMSE)and activities of daily living(ADL)was used to evaluate the cognitive function,and to further evaluate the Hachinski ischemic scale(HIS)for the cognitive impairment patients.Using SPSS 17.0 software,the prevalence of dementia and the major types of dementia were analyzed statistically by independent sample t test and Chi square test.Results:1.The prevalence of dementia is about 14.77%.Alzheimer's disease(AD)and vascular dementia(VD)are the main types of dementia,accounting for 92.85% of dementia.2.There was statistical significance about the differences on the prevalence of dementia in different age(?2=62.894,p<0.05).3.There was no statistical significance about the differences on the prevalence of dementia,AD ad VD in different sex(p>0.05).4.There was statistical significance about the differences on the prevalence of dementia in different marital status(?2=5.169,p<0.05).5.There was statistical significance about the differences on the prevalence of dementia in different marital status(?2=15.416,p<0.05);There were statistically significant differences on average education years between AD group and VD group(t=6.299,p<0.05)? Part two Risk factors of Alzheimer's disease in hospitalized patientsObjective: To analyze the risk factors of Alzheimer's disease in hospitalized patients,so as to provide some reference for preventing Alzheimer's disease and delaying the progress of the disease.Methods: Combined with the first part,182 elderly patients was diagnosed with dementia,and 86 patients who were diagnosed with Alzheimer's disease(AD)were selected as the study group(AD group),and 86 cases of normal cognitive function in the same period were selected as the control group.Recording the age,sex,marriage,education years,smoking history,drinking history,and history of hypertension,diabetes and stroke respectively,and the Mini-Mental State Examination(MMSE)and activities of daily living(ADL)was used to evaluate the cognitive function.Using SPSS 17.0 software,the risk factors for Alzheimer's disease in hospitalized patients were analyzed statistically by independent sample t test,Chi square test and multiple factor Logistic regression analysis.Results:1.There were statistically significant differences on age,marital status,educational level between AD group and control group(p<0.05),while the difference in sex was no statistically significant(p>0.05).2.There were statistically significant differences on the history of hypertension,diabetes,stroke,mild hearing loss or visual impairment between AD group and control group(p<0.05).3.There were statistically significant differences on the scores of MMSE and ADL between AD group and control group(p<0.05).4.The multiple factor Logistic regression analysis showed that diabetes(OR=3.202,95%CI: 1.194~8.584,p<0.05),stroke(OR=2.352,95%CI: 1.007~5.492,p<0.05)and mild hearing or visual impairment(OR=4.290,95%CI: 1.036~17.768,p<0.05)were related to the occurrence of AD in hospitalized patients.Part three Economic burden of Alzheimer's disease in hospitalized patientsObjective: To understand the economic burden of AD and its influencing factors,so as to reduce the economic burden caused by diseases as a reference.Methods: In this study,86 patients with AD were selected from second parts,and 26 cases of AD patients hospitalized from August 2016 to December 2017 were selected as the research subjects,and the related cost and resource utilization of the patients were investigated by questionnaire.Results:1.The median medical cost of direct medical cost for AD patients are 20864.50yuan/year,5010.00yuan/year,11274.00yuan/year and 46690.50 yuan/year respectively.2.AD patients with higher age,widowed spouse,longer treatment duration and poorer cognitive function had more complications and heavier financial burden.Conclusion:1.The prevalence of dementia in hospitalized patients is about 14.77%.Alzheimer's disease and vascular dementia are the main types of Alzheimer's disease.2.Diabetes,stroke,mild hearing loss or impaired vision are independent risk factors for Alzheimer's disease.3.Direct medical cost and indirect cost account for the vast majority of total medical cost,which were the main components of total medical cost for Alzheimer's disease patients.4.The economic burden of patients with Alzheimer's disease is mainly affected by age,marital status,treatment years and poor cognitive function.