Objective:

We sought to investigate incidence and trends of falls and Traumatic brain injury (TBI) in Alzheimer Disease (AD) cohort, and impact on mortality using a large administrative database

Background:

Alzheimer’s disease (AD) is the most common cause of dementia in the elderly, with significant health-care burden. AD patients are more likely to fall and experience traumatic brain injury (TBI) than those without. However, there are no recent population based epidemiological studies to guide designing preventive strategies.

Design/Methods:

Hospitalizations with AD or TBI and age>64 years were extracted from the Nationwide Inpatient Sample (NIS) 2006–2011. A subset of those with falls was identified using provided e-codes. Appropriate weights were attached to approximate national estimates.

Results:

Total hospitalizations from 2006–2011 was 62,949,73; out of which, 15.5% had AD with mean age = 83±7 years and 63.8% females, compared to mean age 78±8 and 56.3% females otherwise. TBI incidence in AD was 1.4% vs. 0.9% in non-AD (p<0.0001). Fall incidence in AD was 11.5% vs. 6.7% in non-AD (p<0.0001), and falls contributed to TBI in 68% cases. Fall incidence in AD increased from 10.5% (2006) to 12.1% (2011) (p<0.0001). TBI incidence in AD with falls also increased from 7.7% (2006) to 10.0% (2011) (p<0.0001). Overall in-hospital mortality was 4.7% in AD vs. 4.5% in non-AD (p<0.0001). Mortality with TBI in AD was 6.9% vs. 4.7% in non-AD (p<0.0001). In AD with falls cohort, mortality with TBI was 7.5% vs. 2.5% without TBI.

Conclusions:

There is a greater incidence of falls and TBI in AD compared to without AD, which is increasing yearly. Falls contribute to majority of TBI incidence in AD. TBI and falls also increase mortality incidence in AD. These findings necessitate investigation into their causes, impact on healthcare, and design of preventive strategies. Disclosure: Dr. Tahir has nothing to disclose. Dr. Al Jarrah has nothing to disclose. Dr. Khawaja has nothing to disclose. Dr. Izzy has nothing to disclose.

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