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A BSTRACTS
categories based on Mini-Mental State Examination (MMSE) scores:
>23 and those < 23.
Results: The following differences were found between dementia(D)
and non-dementia(ND) patients: Proportion with of twice
daily brushings or more: Annual dental visits: 36% (D) vs. 54% (ND);
flosses teeth: 11% (D) vs. 25% (ND); 51% (D) vs. 54% (ND); problems
with teeth:16%(D) vs. 26%(ND); complaining of dental pain:
20% (D) vs.21% (ND); wear dentures: 57% (D) vs. 58% (ND); problems
with dentures: 25% (D) vs. 30% (ND); Two of the comparisons
attained statistical significance(p< .05): annual dental visits(r=.18)
and flossing teeth (r=.18). There were no significant correlations between
the dichotomized MMSE score and the dental variables. In the
dementia group, having at least an annual visit to dentist was significantly
associated with stage of dementia; 71% and 22% had annual
visits among person with mild and moderate or severe stages, respectively
(χ2 = 6.62, df=1, p=.01). However, no other sociodemographic,
cognitive, or neuropsychiatric variables were associated with annual
dental visits.
Conclusion: Although both groups showed substandard levels of
care, persons with dementia had significantly lower levels of dental
care, and this worsened with the stage of the dementia. The study confirms
that need for education of caregivers and increased accessibility
to oral health care in older adults with dementia.
Key Words:
Dental care; Geriatrics; Dementia
A40
Counting Pop-Drops: Emergency Department Re-Visits by Persons
with Dementia.
C. Clevenger, 1,2 D. Khalili, 2 Z. Yang. 3 1. Birmingham/Atlanta
GRECC, Department of Veterans’ Affairs Medical Center, Grayson,
GA; 2. Nell Hodgson Woodruff School of Nursing, Emory University,
Atlanta, GA; 3. Rollins School of Public Health, Emory University,
Atlanta, GA.
BACKGROUND: Twenty-six to forty percent of older emergency
department (ED) patients are estimated to have dementia. We
conducted a pilot study in which persons with dementia (PwD) had
twice the number of ED visits over a one-year period compared to
those without dementia. The purpose of this study is to compare the
pattern of ED use, discharges, and hospital admissions between older
ED re-visitors with and without dementia.
METHODS: The study employed retrospective chart review of
persons over the age of 70 who accessed the ED of an urban academic
medical center ≥ 2 times in 2009 with chief complaints of moderate
severity. We reviewed clinical notes from the ED visit as well as
inpatient and outpatient records for documentation of dementia.
Dates and outcomes of ED visits (admission to hospital or discharge
from ED) were used to calculate interval between visits and variables
of events occurring within 7, 30, 60 and 90 days. We asked the following
research questions: What is the mean number of days between
ED visits for PwD? How likely are PwD to re-visit the ED within 30
days compared to those without dementia? Is there a delay in hospital
admission for PwD as shown by multiple ED discharges prior to
hospital admission?
RESULTS: The study sampled 540 ED visits made by 154 persons;
54 were PwD (35.1%). The mean number of days between ED
visits was 41.5 for those without dementia and 33.7 for PwD
(p=0.160). Persons with dementia made 207 of the 540 total ED visits
(38.3%); 154 of the 386 re-visits (39.9%); and 95 of the 219 30-day revisits
(43.4%). The likelihood ratio of an ED re-visit in = 65 years with at least 1 ED visit
between 1/1/00 and 9/30/07 (N = 4,964). Latent class analysis models
were estimated to identify groups (or classes) with similar numbers of
(1) primary care (PC) visits; (2) outpatient ED visits (i.e. treated and
released); and (3) hospital days within 12 months preceding the index
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