Table 5.
Multivariable Associations
| N=4730 | ACB Sum 1–2 vs. 0 | ACB Sum 3+ vs. 0 | ACB Sum 3+ vs. 1–2 |
|---|---|---|---|
|
| |||
| Variable | OR (95% CI) Adjusted | OR (95% CI) Adjusted | OR (95% CI) Adjusted |
|
| |||
| Predisposing Factors | |||
|
|
|||
| Age (y) | overall ‡ | ||
| 65–70 | ref | ref | ref |
| 70–<80 | 0.82 (0.58, 1.15) | 0.87 (0.62, 1.22) | 1.07 (0.78, 1.47) |
| 80–<90 | 1.03 (0.74, 1.43) | 0.75 (0.54, 1.05) | 0.73 (0.53, 0.99)* |
| 90+ | 1.04 (0.74, 1.47) | 0.67 (0.47, 0.96)* | 0.64 (0.46, 0.90)† |
|
| |||
| Sex | |||
| Male | ref | ref | ref |
| Female | 0.92 (0.78, 1.08) | 1.11 (0.92, 1.32) | 1.20 (1.01, 1.43)* |
|
| |||
| Race/Ethnicity | |||
| White(non-Hispanic) | ref | ref | ref |
| Black(non-Hispanic) | 1.04 (0.78, 1.39) | 0.89 (0.66, 1.22) | 0.86 (0.64, 1.15) |
| Hispanic | 0.92 (0.65, 1.30) | 0.69 (0.47, 1.02) | 0.76 (0.52, 1.10) |
| Other | 0.85 (0.54, 1.34) | 0.80 (0.49, 1.31) | 0.93 (0.57, 1.52) |
|
| |||
| Medical Need Factors | |||
|
|
|||
| Charlson Comorbidity Index | overall ‡ | overall ‡ | |
| 0 or 1 | ref | ref | ref |
| 2 or 3 | 1.15 (0.91, 1.44) | 1.43 (1.10, 1.86)† | 1.25 (0.95, 1.64) |
| 4 or 5 | 1.22 (0.96, 1.55) | 1.67 (1.27, 2.18)‡ | 1.36 (1.04, 1.80)* |
| 6+ | 1.59 (1.24, 2.03)‡ | 1.93 (1.46, 2.54)‡ | 1.21 (0.92, 1.60) |
|
| |||
| Dementia Severity (as defined previously by: CCW diagnosis, CPS and functional status) | overall ‡ | overall ‡ | |
| Non-Dementia | ref | ref | ref |
| Dementia non-severe | 0.71 (0.60, 0.83)‡ | 0.97 (0.81, 1.16) | 1.37 (1.15, 1.63)‡ |
| Dementia severe | 0.55 (0.41, 0.74)‡ | 0.88 (0.65, 1.21) | 1.62 (1.17, 2.22)‡ |
|
| |||
| Use of Antidementia Medication | overall ‡ | overall ‡ | overall ‡ |
| AchEI only | 1.48 (1.16, 1.89)‡ | 2.24 (1.76, 2.85)‡ | 1.51 (1.20, 1.90)‡ |
| Memantine only | 1.95 (1.30, 2.94)‡ | 2.09 (1.37, 3.19)‡ | 1.07 (0.73, 1.57) |
| AchEI + Memantine | 2.40 (1.73, 3.31)‡ | 3.26 (2.36 (4.49)‡ | 1.36 (1.03, 1.80)* |
| None | ref | ref | ref |
|
| |||
| Sensory Limitation | |||
| Yes | 1.01 (0.77, 1.33) | 1.04 (0.77, 1.39) | 1.02 (1.20, 1.90)‡ |
| No | ref | ref | ref |
|
| |||
| Depression | |||
| Yes | 1.29 (1.10, 1.50)‡ | 1.50 (1.28, 1.76)‡ | 1.17 (1.00, 1.37)* |
| No | ref | ref | ref |
|
| |||
| Anxiety | |||
| Yes | 1.00 (0.84, 1.19) | 1.51 (1.27, .181)‡ | 1.52 (1.27, 1.80)‡ |
| No | ref | ref | ref |
|
| |||
| Schizophrenia | |||
| Yes | 1.18 (0.63, 2.20) | 4.10 (2.41, 7.00)‡ | 3.50 (2.11, 5.79)‡ |
| No | ref | ref | ref |
|
| |||
| Parkinson’s Disease | |||
| Yes | 0.92 (0.69, 1.24) | 1.11 (0.82, 1.50) | 1.20 (0.89, 1.62) |
| No | ref | ref | ref |
|
| |||
| Incontinence | |||
| Yes | 0.97 (0.84, 1.12) | 1.14 (0.98. 1.33) | 1.17 (1.01, 1.36)* |
| No | ref | ref | ref |
|
| |||
| Seizure disorder | |||
| Yes | 0.95 (0.67, 1.35) | 1.14 (0.81, 1.61) | 1.19 (0.86, 1.67) |
| No | ref | ref | ref |
|
| |||
| Hypertension | |||
| Yes | 1.72 (1.47, 2.01)‡ | 1.80 (1.52, 2.14)‡ | 1.05 (0.88, 1.25) |
| No | ref | ref | ref |
|
| |||
| Neuropathic Pain | |||
| Yes | 1.12 (0.96, 1.30) | 1.09 (0.93, 1.28) | 0.97 (0.83, 1.14) |
| No | ref | ref | ref |
|
| |||
| Enabling Factors | |||
|
|
|||
| Hospitalization in the last year | |||
| Yes | 1.25 (1.05, 1.50)† | 1.32 (1.09, 1.59)† | 1.05 (0.87, 1.26) |
| No | ref | ref | ref |
|
| |||
| ED visit in the last year | |||
| Yes | 1.00 (0.83, 1.20) | 1.06 (0.87, 1.29) | 1.06 (0.87, 1.26) |
| No | ref | ref | ref |
|
| |||
| Primary Care visit in the last year | |||
| Yes | 0.95 (0.82, 1.11) | 1.03 (0.87, 1.22) | 1.08 (0.92, 1.27) |
| No | ref | ref | ref |
|
| |||
| Specialist visit in the last year | |||
| Yes | 0.99 (0.84, 1.16) | 1.19 (1.00. 1.42)* | 1.20 (1.01, 1.44)* |
| No | ref | ref | ref |
|
| |||
| Geographic region | |||
| Northeast | 1.31 (1.06, 1.61)† | 1.14 (0.91, 1.42) | 0.87 (0.70, 1.08) |
| Midwest | ref | ref | ref |
| South | 1.03 (0.86, 1.22) | 1.00 (0.73, 1.19) | 0.98 (0.81, 1.18) |
| West | 1.15 (0.92, 1.43) | 0.93 (0.73, 1.19) | 0.81 (0.64, 1.03) |
|
| |||
| Low Income Subsidy/Medicaid Eligibility | overall ‡ | ||
| Neither | ref | ref | ref |
| Low income subsidy only | 1.18 (0.93, 1.49) | 1.24 (0.96, 1.60) | 1.05 (0.83, 1.35) |
| Medicaid | 1.14 (0.97, 1.34) | 1.40 (1.17, 1.66)‡ | 1.22 (1.03, 1.45)* |
*
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