• Mary Lynn Davis-Ajami, Chiang-Hua Chang, Sumedha Gupta, Babar Ali Khan, Craig A Solid, Husam El Sharu, Malaz Boustani, YatesBrandon ABABrandon A. Yates is a doctoral candidate and predoctoral fellow, Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, Indiana., and Kosali Simon.
• Mary Lynn Davis-Ajami is chair and professor, Department of Nursing, Merrimack College, North Andover, Massachusetts.
• Am. J. Crit. Care. 2023 Jul 1; 32 (4): 249255249-255.

BackgroundIntensive care unit (ICU) utilization has increased among patients with Alzheimer disease and related dementia (ADRD), although outcomes are poor.ObjectivesTo compare ICU discharge location and subsequent mortality between patients with and patients without ADRD enrolled in Medicare Advantage.MethodsThis observational study used Optum's Clinformatics Data Mart Database from years 2016 to 2019 and included adults aged >67 years with continuous Medicare Advantage coverage and a first ICU admission in 2018. Alzheimer disease and related dementia and comorbid conditions were identified from claims. Outcomes included discharge location (home vs other facilities) and mortality (within the same calendar month of discharge and within 12 months after discharge).ResultsA total of 145 342 adults met inclusion criteria; 10.5% had ADRD and were likely to be older, female, and have more comorbid conditions. Only 37.6% of patients with ADRD were discharged home versus 68.6% of patients who did not have ADRD (odds ratio [OR], 0.40; 95% CI, 0.38-0.41). Both death in the same month as discharge (19.9% vs 10.3%; OR, 1.54; 95% CI, 1.47-1.62) and death in the 12 months after discharge (50.8% vs 26.2%; OR, 1.95; 95% CI, 1.88-2.02) were twice as common among patients with ADRD.ConclusionsPatients with ADRD have lower home discharge rates and greater mortality after an ICU stay than patients without ADRD.©2023 American Association of Critical-Care Nurses.

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