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The relationship between social determinants of health and hospitalization among American Indian and Alaska native older adults with and without dementia
Ruqoyat Abdulsalam, Joan M. O’Connell, Luohua Jiang, Laura Grau. Alzheimer s & Dementia, 2023-06-01
Topic: Risk, prevention and care in population studies
Abstract Background Although American Indian and Alaska Native (AI/AN) adults are at high risk for dementia, little is known about their hospital inpatient utilization. AI/ANs who access health services through the Indian Health Service and Tribal health programs experience disparities in income, education, and health care access. The aim of this study is to examine patient characteristics, including social determinations of health (SDOH), that are associated with having one or more hospital admissions among AI/AN adults aged 65+ years, and to understand how dementia influences their risk of hospitalization. Method We analyzed fiscal year 2013 hospital utilization data from Indian Health Service and Tribal health programs for 19,025 AI/AN adults aged ≥65 years who lived in 31 counties across 12 project sites. Among these adults, 1,464 had dementia. We estimated a logistic regression model, with project site fixed‐effects and county‐level random effects, to examine associations between health status, health coverage, and 3 SDOH (educational attainment, household income, and geographical access to hospital facilities) with being hospitalized 1+ times during the year. Result The odds of hospitalization were higher for patients with dementia (Odds Ratio (OR) = 2.56; 95% CI: 2.19‐3.01, p 45 minutes from their community to a hospital, compared to 15 minutes or less, had lower odds of hospitalization (OR = 0.63; 95% CI: 0.55‐0.72, p< 0.01). Conclusion Understanding and addressing SDOH associated with hospitalizations among AI/AN older adults, with and without dementia, may aid in the development of strategies that reduce preventable hospitalization. In‐depth studies are needed to understand the health risks of AI/AN with dementia who have Medicaid coverage and who live far from hospital services.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Abdulsalam, R., O’Connell, J. M., Jiang, L., & Grau, L. (2023). The relationship between social determinants of health and hospitalization among American Indian and Alaska native older adults with and without dementia. Alzheimer s & Dementia. https://doi.org/10.1002/alz.068238
Vancouver
Abdulsalam R, O’Connell JM, Jiang L, Grau L. The relationship between social determinants of health and hospitalization among American Indian and Alaska native older adults with and without dementia. Alzheimer s & Dementia. 2023. doi:10.1002/alz.068238.
BibTeX
@article{abdulsalam2023-94e9d0a1,
author = {Abdulsalam, Ruqoyat and O’Connell, Joan M. and Jiang, Luohua and Grau, Laura},
title = {{The relationship between social determinants of health and hospitalization among American Indian and Alaska native older adults with and without dementia}},
journal = {Alzheimer s \& Dementia},
year = {2023},
doi = {10.1002/alz.068238},
url = {https://doi.org/10.1002/alz.068238}
}
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.
Key findings
- The aim of this study is to examine patient characteristics, including social determinations of health (SDOH), that are associated with having one or more hospital admissions among AI/AN adults aged 65+ years, and to understand how dementia influences their risk of hospitalization.
- Result The odds of hospitalization were higher for patients with dementia (Odds Ratio (OR) = 2.56; 95% CI: 2.19‐3.01, p 45 minutes from their community to a hospital, compared to 15 minutes or less, had lower odds of hospitalization (OR = 0.63; 95% CI: 0.55‐0.72, p< 0.01).
- Conclusion Understanding and addressing SDOH associated with hospitalizations among AI/AN older adults, with and without dementia, may aid in the development of strategies that reduce preventable hospitalization.
Why it matters
This study found that American Indian and Alaska Native adults aged 65 and older with dementia had higher odds of hospitalization than those without dementia. The findings concern hospital utilization and social determinants of health, not treatment, cure, or prevention.
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Study details
- Effect sizeOR = 0.63
- Evidence strengthLow
How this study scored 32/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (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 | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization 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 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 | 1 / 4 | Last-listed author Laura Grau: h-index 9 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of California, Irvine: institution h-index 1,195 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 32 / 100 | — |
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