Hospitals bad sign for Alzheimer's

WASHINGTON - For people with Alzheimer's disease, a hospital stay may prove catastrophic.

A new study highlights the lingering ill effects: Being hospitalized seems to increase the chances of Alzheimer's patients moving into a nursing home - or even dying - within the next year, Harvard researchers reported Monday. The risk is higher if those patients experience what's called delirium, a state of extra confusion and agitation, during their stay.

It's not clear exactly why, although specialists say delirium is especially bad for an already damaged brain. The researchers, and independent Alzheimer's experts, agree that caregivers need to know the risk so they can help a loved one with dementia avoid the hospital if at all possible.

"It's a very stressful time, being in the hospital," says lead researcher Tamara Fong, of the Harvard-affiliated Beth Israel Deaconess Hospital and Hebrew SeniorLife in Boston. Often families say, "Dad was never the same after he had that surgery and he was confused."

About 5.4 million Americans have Alzheimer's or similar dementias, and the incidence of the disease is increasing as the population gets older. The disease will cost Medicare and Medicaid about $140 billion this year alone, according to the Alzheimer's Association. Alzheimer's patients gradually lose the ability to manage their diabetes, high blood pressure and other chronic ailments, or even to convey that they're feeling symptoms until an illness becomes serious, explains William Thies, the association's scientific director.

The new study examined medical records for 771 Alzheimer's patients who were living at home and fairly high-functioning, to see what happened if they wound up in the hospital. About half did, mostly for things such as fainting or falls, pneumonia and chest pain. A quarter suffered delirium in the hospital.

Each year, about 4 percent of the patients who weren't hospitalized entered a nursing home and 2 percent died. Yet 29 percent of the hospitalized Alzheimer's patients wound up in a nursing home - as did a surprising 43 percent of those who suffered delirium, the study found.

Of those who survived the initial hospitalization, 9 percent died in the following year, as did 15 percent of those who'd suffered delirium, Fong reported Monday in the journal Annals of Internal Medicine.

The study can't explain the link.