ArticleJournal of the American Medical Directors Association2026
Stage of Disease Among Hospitalized Persons Living With Dementia: A Multisite Study.
Article in Journal of the American Medical Directors Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine dementia stage and factors associated with stage among hospitalized older adults with Alzheimer's disease and related dementias (ADRD).
designSecondary analysis of baseline data from the multisite ADRD-Palliative Care (ADRD-PC) clinical trial screening cohort. SETTING AND
participantsFive US medical centers; hospitalized adults aged ≥55 years with ADRD identified at admission. Dementia stage was classified using the Global Deterioration Scale (GDS) as mild (GDS 3-4), moderate (GDS 5-6), or severe (GDS 7).
methodsMultinomial logistic regression identified demographic and clinical characteristics independently associated with dementia stage. Independent variables included age, race, admitting service (general medicine, subspecialty/surgery, intensive care unit), and dementia diagnosis; models were clustered by site.
resultsAmong 6303 hospitalized patients with ADRD, 39.3% had mild dementia, 57.8% moderate, and 2.9% severe. Compared with those with mild dementia, individuals with moderate dementia had higher odds of being older [75-84 years: adjusted odds ratio (aOR), 1.34; 95% CI, 1.17-1.53; ≥85 years: aOR, 2.02; 95% CI, 1.76-2.33], Black (aOR, 1.45; 95% CI, 1.27-1.66), less often admitted to subspecialty/surgical services (aOR, 0.65; 95% CI, 0.58-0.73), and more often diagnosed with Alzheimer's disease (aOR, 1.85; 95% CI, 1.62-2.12). Individuals with severe dementia had higher odds of being Black (aOR, 2.43; 95% CI 1.72-3.43) or Asian (aOR, 2.95; 95% CI, 1.57-5.54), less often admitted to subspecialty/surgical services (aOR, 0.39; 95% CI, 0.26-0.58), and more often diagnosed with Alzheimer's disease (aOR, 2.67; 95% CI, 1.9-3.77). CONCLUSIONS AND IMPLICATIONS: Moderate-stage dementia was the most common stage among hospitalized patients with ADRD. Patients with moderate or severe dementia were more likely to be older, identify as Black, be admitted to general medical services, and have Alzheimer's disease. Staging and related characteristics may guide hospital-based interventions to improve care for people with ADRD.
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