{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:53:17Z","timestamp":1780631597932,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hospitalized persons living with dementia (PLWD) often experience behavioral symptoms that challenge medical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to identify clinical practices and outcomes associated with behavioral symptoms in hospitalized PLWD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Settings and Participants<\/jats:title><jats:p>The study included PLWD (65+) admitted to one of severe health system hospitals in 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Behavioral symptoms were defined as the presence of (1) a psychoactive medication for behavioral symptoms; (2) an order for physical restraints or constant observation; and\/or (3) physician documentation of delirium, encephalopathy, or behavioral symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome and Measures<\/jats:title><jats:p>Associations between behavioral symptoms and patient characteristics and hospital practices (e.g., bladder catheter) were examined. Multivariable logistic\/linear regression was used to evaluate the association between behavioral symptoms and clinical outcomes (e.g., mortality).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of hospitalized PLWD (<jats:italic>N<\/jats:italic>\u2009=\u20098637), the average age was 84.5 years (IQR\u2009=\u200979\u221290), 61.7% were female, 60.1% were white, and 9.4% (<jats:italic>n<\/jats:italic>\u2009=\u2009833) were Hispanic. Behavioral symptoms were identified in 40.6% (<jats:italic>N<\/jats:italic>\u2009=\u20093606) of individuals. Behavioral symptoms were significantly associated with male gender (40.3% vs. 36.9%, <jats:italic>p<\/jats:italic>\u2009=\u2009.001), white race (62.7% vs. 58.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and residence in a facility prior to admission (26.6% vs. 23.7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Regarding hospital practices, indwelling bladder catheters (11.2% vs. 6.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and dietary restriction (41.9% vs. 33.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) were associated with behavioral symptoms. In multivariable models, behavioral symptoms were associated with increased hospital mortality (odds ratio [OR]: 1.90, CI95%: 1.57\u22122.29), length of stay (parameter estimate: 2.10, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), 30\u2010day readmissions (OR: 1.14, CI95%: 1.014\u20131.289), and decreased discharge home (OR: 0.59, CI95%: 0.53\u22120.65, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Given the association between behavioral symptoms and poor clinical outcomes, there is an urgent need to improve the provision of care for hospitalized PLWD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.12921","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T08:42:50Z","timestamp":1660639370000},"page":"702-709","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Hospital practices and clinical outcomes associated with behavioral symptoms in persons with dementia"],"prefix":"10.1002","volume":"17","author":[{"given":"Rachel","family":"Tannenbaum","sequence":"first","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health  Hempstead New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Boltz","sequence":"additional","affiliation":[{"name":"Ross and Carol Nese College of Nursing The Pennsylvania State University  University Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anum","family":"Ilyas","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Gromova","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Ardito","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutahira","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenyth","family":"Mercep","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Qiu","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele","family":"Wolf\u2010Klein","sequence":"additional","affiliation":[{"name":"Institute of Health System Science, Feinstein Institutes for Medical Research Northwell Health  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaldy S.","family":"Tan","sequence":"additional","affiliation":[{"name":"Departments of Neurology &amp; 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