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Editor's view
Nathalie van der Velde. Age and Ageing, 2023-04-01
Topic: Risk, prevention and care in population studies
In-hospital death among nursing home residents with dementia has been associated with poorer quality of end-of-life care. The proportion of nursing home residents being admitted to hospital in the past month of their lives ranges from 25 to 70%, suggesting that hospital admissions are a common response to end-of-life problems. Factors associated with more ED visits included sociodemographic (social economic position, ethnicity) factors, clinical factors (underlying disease as individual characteristics) and service characteristics: with regard to service level factors, the number of available nursing home beds in the region was associated with the number of ED visits at the end-of-life. Nevertheless, no significant effect on their primary outcome—proportion of hospital admissions—was achieved. It has been suggested that through cognitive decline, CSVD can also impair gait and thus contribute to risk of falls. For other lesion types, such as infarcts and cerebral microbleeds, the results were less consistent and meta-analysis was not possible due to heterogeneity in the respective CSVD assessments and gait measurement. With improved welfare, alcohol consumption may rise accordingly, although conversely risk-drinking is commonly associated with lower SES. They showed that both alcohol consumption and the number of risk consumers have increased considerably among 85 year olds. The only factor identified to be associated with an increased likelihood of risk consumption was male sex. Atrial fibrillation is associated with cognitive decline. In a Belgian nationwide dataset of 240,000 persons with atrial fibrillation, they showed that NOACs were associated with a significantly lower risk of dementia (9% risk reduction) compared with VKAs, likely driven by apixaban and edoxaban use. This finding was associated with lower risks of vascular and other/unspecified dementia, whereas the risk of Alzheimer’s disease was similar. They conclude that regrettably they do not seem to have fully taken account of older adults for whom UTI is a common presentation.
Key findings
- In-hospital death among nursing home residents with dementia has been associated with poorer quality of end-of-life care.
- The proportion of nursing home residents being admitted to hospital in the past month of their lives ranges from 25 to 70%, suggesting that hospital admissions are a common response to end-of-life problems.
- Factors associated with more ED visits included sociodemographic (social economic position, ethnicity) factors, clinical factors (underlying disease as individual characteristics) and service characteristics: with regard to service level factors, the number of available nursing home beds in the region was associated with the number of ED visits at the end-of-life.
- Nevertheless, no significant effect on their primary outcome—proportion of hospital admissions—was achieved.
- It has been suggested that through cognitive decline, CSVD can also impair gait and thus contribute to risk of falls.
Why it matters
This review notes that in-hospital death among nursing home residents with dementia is associated with poorer quality of end-of-life care, and that hospital admissions in the last month of life are common. It also reports that an intervention had no significant effect on the proportion of hospital admissions.
Study details
- Study designsystematic review
- Participants240,000
- Evidence strengthHigh
How this study scored 54/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it. We have no data on institution's track record, so that was left out: it earned 52 of the 97 points we could judge it on, which is 54 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 4 / 4 | 240,000 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Nathalie van der Velde: h-index 58 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 52 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 52 of the 97 points we could judge it on is 54 out of 100. |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
van der Velde, N. (2023). Editor's view. Age and Ageing. https://doi.org/10.1093/ageing/afad065
Vancouver
van der Velde N. Editor's view. Age and Ageing. 2023. doi:10.1093/ageing/afad065.
BibTeX
@article{vandervelde2023-51de44c0,
author = {van der Velde, Nathalie},
title = {{Editor's view}},
journal = {Age and Ageing},
year = {2023},
doi = {10.1093/ageing/afad065},
url = {https://doi.org/10.1093/ageing/afad065}
}