Home › Research › Risk factors
Mortality and Institutionalization After a Potentially Preventable Hospitalization Among People with Dementia
Elham Mahmoudi. Innovation in Aging, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract Potentially preventable hospitalizations (PPHs) are costly and harmful to all older adults. There is a paucity of evidence on adverse health events of PPH among patients with dementia. We examined the effect of any PPH in 2018 on mortality and long-term institutionalization in 2019 among Medicare beneficiaries with dementia. We used 20% random sample of 2018-2019 Medicare claims data to select people with dementia who continuously enrolled in 2018 and 2019 traditional Medicare with at least one hospitalization in 2018 (n = 67,110). We also identified people with at least one PPH in 2018 (20.1% of the sample). We used the average treatment effect on treated method, matching the characteristics of people with and without PPH and applying robust standard errors. Our models controlled for age, sex, race/ethnicity, frailty index, rurality, neighborhood disadvantaged index, and number of primary care providers and hospitals at the county level. The average effect of at least one PPH on mortality was 33.5% (95% CI: 32.7%-34.3%) among people with PPH compared to 28.8% (95% CI: 28.3%-29.2%) among those with no PPH. Thus, among dementia patients, a PPH increased the risk of mortality by 4.7 percentage points (PP) (95% CI: 3.8%-5.6%). Effect of any PPH on long-term institutionalization was 21.1% (95% CI: 20.3%-22.0%) among people with PPH compared to 17.9% (95% CI: 17.4%-18.3%) among those with no PPH. Having any PPH increased the risk of long-term institutionalization by 3.3 PP (95% CI: 2.3%-4.2%). PPHs increase the risks of mortality and long-term institutionalization among older adults with dementia.
Key findings
- The average effect of at least one PPH on mortality was 33.5% (95% CI: 32.7%-34.3%) among people with PPH compared to 28.8% (95% CI: 28.3%-29.2%) among those with no PPH.
- Effect of any PPH on long-term institutionalization was 21.1% (95% CI: 20.3%-22.0%) among people with PPH compared to 17.9% (95% CI: 17.4%-18.3%) among those with no PPH.
Why it matters
Among Medicare beneficiaries with dementia, having a potentially preventable hospitalization was linked to a higher risk of death and long-term institutionalization. This concerns hospital care and outcomes, not treating, curing or preventing Alzheimer's disease itself.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Participants67,110
- Effect size20.1%; 33.5%; 32.7%
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 67,110 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| 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 | 2 / 4 | Last-listed author Elham Mahmoudi: h-index 29 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — 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 |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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
Mahmoudi, E. (2025). Mortality and Institutionalization After a Potentially Preventable Hospitalization Among People with Dementia. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.169
Vancouver
Mahmoudi E. Mortality and Institutionalization After a Potentially Preventable Hospitalization Among People with Dementia. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.169.
BibTeX
@article{mahmoudi2025-83f0d4ae,
author = {Mahmoudi, Elham},
title = {{Mortality and Institutionalization After a Potentially Preventable Hospitalization Among People with Dementia}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.169},
url = {https://doi.org/10.1093/geroni/igaf122.169}
}
Related studies in Risk factors
Also tagged “prevalence”
1,224 studies in the library carry the topic tag “prevalence”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,224 tagged studies.