Table 4.
Univariable Associations
| N=4730 | ACB Sum 1–2 vs. 0 | ACB Sum 3+ vs. 0 | ACB Sum 3+ vs. 1–2 |
|---|---|---|---|
|
| |||
| Variable | OR (95% CI) Unadjusted | OR (95% CI) Unadjusted | OR (95% CI) Unadjusted |
|
| |||
| Predisposing Factors | |||
|
|
|||
| Age (y) | overall ‡ | overall ‡ | |
| 65–70 | ref | ref | ref |
| 70–<80 | 0.72 (0.52, 1.00)* | 0.75 (0.55, 1.03) | 1.04 (0.77, 1.41) |
| 80–<90 | 0.82 (0.60, 1.11) | 0.55 (0.40, 0.74)‡ | 0.67 (0.50, 0.89)† |
| 90+ | 0.75 (0.54, 1.02) | 0.40 (0.29, 0.55)‡ | 0.54 (0.40, 0.73)‡ |
|
| |||
| Sex | |||
| Male | ref | ref | ref |
| Female | 0.94 (0.80, 1.09) | 1.08 (0.91, 1.27) | 1.15 (0.98, 1.35) |
|
| |||
| Race/Ethnicity | |||
| White(non-Hispanic) | ref | ref | ref |
| Black(non-Hispanic) | 1.21 (0.92, 1.57) | 1.14 (0.86, 1.51) | 0.95 (0.72, 1.24) |
| Hispanic | 1.04 (0.75, 1.45) | 0.94 (0.66, 1.33) | 0.90 (0.63, 1.27) |
| Other | 0.95 (0.62, 1.46) | 0.87 (0.55, 1.38) | 0.92 (0.57, 1.47) |
|
| |||
| Medical Need Factors | |||
|
|
|||
| Charlson Comorbidity Index | overall ‡ | overall ‡ | overall † |
| 0 or 1 | ref | ref | ref |
| 2 or 3 | 1.25 (1.00, 1.55)* | 1.60 (1.25, 2.05)‡ | 1.28 (0.99, 1.67) |
| 4 or 5 | 1.44 (1.16, 1.80)‡ | 2.15 (1.68, 2.75)‡ | 1.49 (1.15, 1.92)† |
| 6+ | 2.00 (1.63, 2.46)‡ | 2.84 (2.25, 3.59)‡ | 1.42 (1.12, 1.81)† |
|
| |||
| Dementia Severity (as defined previously by: CCW diagnosis, CPS and functional status) | overall † | overall † | overall ‡ |
| Non-Dementia | ref | ref | ref |
| Dementia non-severe | 0.85 (0.73, 0.98)* | 1.31 (1.12, 1.53)‡ | 1.54 (1.32, 1.80)‡ |
| Dementia severe | 0.64 (0.49, 0.84)† | 1.04 (0.79, 1.37) | 1.62 (1.21, 2.18)‡ |
|
| |||
| Use of Antidementia Medication | overall ‡ | overall ‡ | overall ‡ |
| AchEI only | 125 (0.99, 1.57) | 1.97 (1.58, 2.46)‡ | 1.58 (1.27, 1.96)‡ |
| Memantine only | 1.51 (1.02, 2.24)* | 1.90 (1.28, 2.84)† | 1.26 (0.87, 1.81) |
| AchEI + Memantine | 1.85 (1.36, 2.51)‡ | 2.88 (2.13, 3.89)‡ | 1.56 (1.20, 2.02)‡ |
| None | ref | ref | ref |
|
| |||
| Sensory Limitation | |||
| Yes | 0.93 (0.72, 1.20) | 0.93 (0.71, 1.22) | 1.00 (0.76. 1.32) |
| No | ref | ref | ref |
|
| |||
| Depression | |||
| Yes | 1.38 (1.20, 1.59)‡ | 2.03 (1.76, 2.35)‡ | 1.47 (1.28, 1.70)‡ |
| No | ref | ref | ref |
|
| |||
| Anxiety | |||
| Yes | 1.04 (0.88, 1.23) | 1.70 (1.44, 2.00)‡ | 1.63 (1.39, 1.93)‡ |
| No | ref | ref | ref |
|
| |||
| Schizophrenia | |||
| Yes | 1.10 (0.60, 2.03) | 4.47 (2.71, 7.38)‡ | 4.05 (2.50, 6.56))‡ |
| No | ref | ref | ref |
|
| |||
| Parkinson’s Disease | |||
| Yes | 0.86 (0.64, 1.14) | 1.08 (0.81, 1.43) | 1.26 (0.94, 1.68) |
| No | ref | ref | ref |
|
| |||
| Incontinence | |||
| Yes | 0.95 (0.83, 1.09) | 1.09 (0.95, 1.26) | 1.15 (0.99, 1.33) |
| No | ref | ref | ref |
|
| |||
| Seizure disorder | |||
| Yes | 1.05 (0.75, 1.46) | 1.53 (1.11, 2.11)† | 1.46 (1.06, 2.00)* |
| No | ref | ref | ref |
|
| |||
| Hypertension | |||
| Yes | 1.78 (1.52, 2.07)‡ | 1.86 (1.58, 2.19)‡ | 1.05 (0.88, 1.24) |
| No | ref | ref | ref |
|
| |||
| Neuropathic Pain | |||
| Yes | 1.29 (1.13, 1.48)‡ | 1.37 (1.19, 1.59)‡ | 1.06 (0.92. 1.23) |
| No | ref | ref | |
|
| |||
| Enabling Factors | |||
|
|
|||
| Hospitalization in the last year | |||
| Yes | 1.56 (1.36, 1.79)‡ | 1.89 (1.64, 2.19)‡ | 1.21 (1.05, 1.40)† |
| No | ref | ref | ref |
|
| |||
| ED visit in the last year | |||
| Yes | 1.40 (1.21, 1.62)‡ | 1.76 (1.50, 2.06)‡ | 1.26 (1.07, 1.48)† |
| No | ref | ref | ref |
|
| |||
| Primary Care visit in the last year | |||
| Yes | 1.02 (0.88, 1.18) | 1.10 (0.94, 1.28) | 1.08 (0.92 (1.26) |
| No | ref | ref | ref |
|
| |||
| Specialist visit in the last year | |||
| Yes | 1.19 (1.03, 1.38)* | 1.43 (1.22, 1.67)‡ | 1.20 (1.02, (1.41)* |
| No | ref | ref | ref |
|
| |||
| Geographic region | overall * | overall * | |
| Northeast | 1.35 (1.11, 1.65)† | 1.26 (1.02, 1.55)* | 0.93 (0.76, 1.14) |
| Midwest | ref | ref | ref |
| South | 1.06 (0.90, 1.25) | 1.16 (0.98, 1.38) | 1.10 (0.92, 1.31) |
| West | 1.12 (0.91, 1.38) | 0.92 (0.74, 1.16) | 0.82 (0.66, 1.04) |
|
| |||
| Low Income Subsidy/Medicaid Eligibility | overall * | overall ‡ | overall ‡ |
| Neither | ref | ref | ref |
| Low income subsidy only | 1.26 (1.00, 1.59)* | 1.47 (1.15, 1.87)† | 1.16 (0.92, 1.47) |
| Medicaid | 1.21 (1.05, 1.40)* | 1.61 (1.38, 1.87)‡ | 1.33 (1.14, 1.55)‡ |
*
p<0.05;
†
p<0.01;
‡
<0.001
ACB = Anticholinergic Cognitive Burden; OR = Odds Ratio; CCW = Chronic Conditions Warehouse; CPS = Cognitive Performance Scale; AchEI = Acetylcholinesterase Inhibitor; ED = Emergency Department