ArticleBMJ open2019
Joint impact of dementia and frailty on healthcare utilisation and outcomes: a retrospective cohort study of long-stay home care recipients.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Frailty and Health Outcomes in People 65 Years or Older Living With Dementia: A Systematic Review of the Literature.Journal of the American Geriatrics Society · 2026Pooled it
- Mental Illness Prevalence Among Ontario Home Care Clients: Variation by Urban/Rural Residence and Deprivation Measures: Prévalence de la maladie mentale chez les clients de soins à domicile en Ontario : variation selon la résidence urbaine/rurale et les mesures de défavorisation.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Article
- Alzheimer's disease and related dementias state policies and mortality in the United States: A descriptive study.Journal of Alzheimer's disease : JAD · 2026Article
- Medicare costs and home time loss among fee-for-service beneficiaries by frailty and dementia status.The Journal of frailty & aging · 2026Article
- The Impact of Frailty, Activity of Daily Living, and Malnutrition on Mortality in Older Adults with Cognitive Impairment and Dementia.Nutrients · 2025Article
- Network Analyses to Explore Comorbidities Among Older Adults Living With Dementia.Journal of the American Geriatrics Society · 2025Article
- Frailty, malnutrition, healthcare utilization, and mortality in patients with dementia and cognitive impairment obtained from hospital administrative data.Frontiers in medicine · 2025Article
- Joint predictability of physical frailty/pre-frailty and subjective memory complaints on mortality risk among cognitively unimpaired older adults.European journal of ageing · 2023Article
- Article
- Health service use before and after dementia diagnosis: a retrospective matched case-control study.BMJ open · 2022Article
- Derivation and validation of a 90-day unplanned hospital readmission score in older patients discharged form a geriatric ward.European geriatric medicine · 2022Article
- Dementia increases mortality beyond effects of comorbid conditions: A national registry-based cohort study.European journal of neurology · 2021Article
- Potentially inappropriate medication among people with dementia: towards individualized decision-making.European geriatric medicine · 2021Review
- Trajectories of health system use and survival for community-dwelling persons with dementia: a cohort study.BMJ open · 2020Article
- Effect of mortality in cost-effectiveness modeling of disease-modifying treatment for Alzheimer's disease.Alzheimer's & dementia (Amsterdam, Netherlands)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine the associations between dementia and 1-year health outcomes (urgent hospitalisation, long-term care (LTC) admission, mortality) among long-stay home care recipients and the extent to which these associations vary by clients' frailty level.
designA retrospective cohort study using linked clinical and health administrative databases.
settingHome care in Ontario, Canada.
participantsLong-stay (≥60 days) care clients (n=153 125) aged ≥50 years assessed between April 2014 and March 2015.
main outcome measuresDementia was ascertained with a validated administrative data algorithm and frailty with a 66-item frailty index (FI) based on a previously validated FI derived from the clinical assessment. We examined associations between dementia, FI and their interactions, with 1-year outcomes using multivariable Fine-Gray competing risk (urgent hospitalisation and LTC admission) and Cox proportional hazards (mortality) models.
resultsClients with dementia (vs without) were older (mean±SD, 83.3±7.9 vs 78.9±11.3 years, p<0.001) and more likely to be frail (30.3% vs 24.2%, p<0.001). In models adjusted for FI (as a continuous variable) and other confounders, clients with dementia showed a lower incidence of urgent hospitalisation (adjusted subdistribution HR (sHR)=0.84, 95% CI: 0.83 to 0.86) and mortality rate (adjusted HR=0.87, 95% CI: 0.84 to 0.89) but higher incidence of LTC admission (adjusted sHR=2.60, 95% CI: 2.53 to 2.67). The impact of dementia on LTC admission and mortality was significantly modified by clients' FI (p<0.001 interaction terms), showing a lower magnitude of association (ie, attenuated positive (for LTC admission) and negative (for mortality) association) with increasing frailty.
conclusionsThe strength of associations between dementia and LTC admission and death (but not urgent hospitalisation) among home care recipients was significantly modified by their frailty status. Understanding the public health impact of dementia requires consideration of frailty levels among older populations, including those with and without dementia and varying degrees of multimorbidity.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.