Comprehensive Dementia Screening Identifies Patients With Poor Health Outcomes and Higher Healthcare Utilization

Q: What screening program was implemented at hospital admission to identify dementia or cognitive impairment?

The program used EHR alerts for dementia plus administration of the 4AT and AD8 at admission in inpatient medical/surgical units.

Q: How did diagnosed dementia and undiagnosed cognitive impairment differ in length of stay?

Diagnosed dementia patients had lower length of stay (7.5 vs. 8.3 days), while those with undiagnosed cognitive impairment had higher length of stay (9.6 vs. 8.3 days).

Q: What impact did cognitive impairment status have on readmission and costs?

Diagnosed dementia patients showed a higher probability of 90-day readmission (17.5% vs. 15.1%). Patients with any cognitive impairment incurred lower costs overall (502K vs. 573K), with differences mainly among those discharged home.

Sep 29, 2026

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Comprehensive dementia screening at hospital admission used electronic health record alerts plus administration of 4AT and AD8 in inpatient medical/surgical units to identify cognitive impairment and delirium status. Patients were analyzed with Poisson, logistic, and generalized linear regressions to compare length of stay, readmissions, prior hospitalizations, and costs. Over 16 months, 11,180 encounters were identified, showing diagnosed dementia with lower LOS yet higher 90-day readmission probability versus undiagnosed cognitive impairment. Any cognitive impairment was associated with lower costs, highlighting the need for early recognition and tailored care.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Session 9020 (PAPER)

Late Breaking: Alzheimer’s Disease, Including Alzheimer’s Disease—Related Dementias V

Study Approach

Results: Length of Stay, Readmission, Prior Hospitalizations, Costs

Conclusion

1276 Innovation in Aging, 2025, Vol. 9, No. S2 SESSION 9020 (PAPER) LATE BREAKING: ALZHEIMER’S DISEASE, INCLUDING ALZHEIMER’S DISEASE—RELATED DEMENTIAS V Abstract citation ID: igaf122.4259 COMPREHENSIVE DEMENTIA SCREENING IDENTIFIES PATIENTS WITH POOR HEALTH OUTCOMESAND HIGHER HEALTHCARE UTILIZATION Nabeel Qureshi1, Pamela Roberts1, Nancy Sicotte1, Drew Hirsch2, Mitzi Gonzales2, Sarah Kremen2, and Zaldy Tan2, 1. Cedars-Sinai Medical Centers, Los Angeles, California, United States, 2. Cedars-Sinai Medical Center, Los Angeles, California, United States There are 6.9 million persons living with dementia in the United States, and over 40% of hospitalized patients age 70+ have dementia. Detection rates in hospitals are less than 50%, likely underestimating the true burden. We implemented a comprehensive program to identify cognitive impairment at hospital admission, using a tripartite approach (EHR alerts for dementia, and administration of the 4AT and AD8) in inpatient medical/ surgical units. Patients were grouped by screening results and delirium status. We conducted Poisson, logistic, and generalized linear regressions to assess differences in length of stay (LOS), readmission rates, prior hospitalizations, and costs between those with and without cognitive impairment. Over the first 16 months, we identified 11,180 patient encounters. Diagnosed dementia patients had lower LOS (7.5 vs. 8.3 days, p < 0.001), while those with undiagnosed cognitive impairment had higher LOS (9.6 vs. 8.3 days, p < 0.001) . Diagnosed dementia patients had a higher probability of 90-day readmission (17.5% vs. 15.1%, p < 0.05), and more hospitalizations in the prior 6 months (6.5 vs. 4.5, p < 0.001). Patients with potential cognitive impairment but no delirium also had more prior hospitalizations (5.1 vs. 4.5, p < 0.01). Patients with any cognitive impairment incurred lower costs (502K vs. 573K, p < 0.001), with differences observed primarily among those discharged home. Implementing systematic screening for cognitive impairment at hospital admission reveals significant differences in health outcomes by dementia status. Early recognition and tailored care strategies for cognitively impaired patients are crucial to improving hospital outcomes.

FAQs

What screening program was implemented at hospital admission to identify dementia or cognitive impairment?

The program used EHR alerts for dementia plus administration of the 4AT and AD8 at admission in inpatient medical/surgical units.

How did diagnosed dementia and undiagnosed cognitive impairment differ in length of stay?

Diagnosed dementia patients had lower length of stay (7.5 vs. 8.3 days), while those with undiagnosed cognitive impairment had higher length of stay (9.6 vs. 8.3 days).

What impact did cognitive impairment status have on readmission and costs?

Diagnosed dementia patients showed a higher probability of 90-day readmission (17.5% vs. 15.1%). Patients with any cognitive impairment incurred lower costs overall (502K vs. 573K), with differences mainly among those discharged home.

Sep 29, 2026

Upload by Aran