Alzheimer’s Centers in US Hospitals: Enough to Adequately Address Dementia Care Nationwide?

Abstract

Objectives: To investigate the availability of Alzheimer’s Centers (ACs) in US hospitals. Methods: Utilizing the American Hospital Association Annual Survey, Area Health Resource File, and US Census (n = 3251), we employed multivariable logistic regression to examine hospital, county, and regional predictors of AC availability. Results: Large hospitals (>399 beds) had approximately 14 times higher odds of having an AC than small hospitals (<50 beds; OR = 14.0; 95% CI = 6.44 – 30.46). Counties with a higher proportion of Latino residents, relative to non-Latino Whites, had lower odds of having an AC (OR = .05; 95% CI = .01 – .41). Northeastern (OR = 1.92; 95% CI = 1.15 – 3.22) and Midwestern (OR = 2.12; 95% CI = 1.34 – 3.37) hospitals had higher odds of having an AC than Southern hospitals. Discussion: To address dementia needs and disparities, investment in a national infrastructure is critical.

Keywords

dementia environment ethnicity health services Hispanic health

Get full access to this article

View all access options for this article.

References

Alzheimer’s disease facts and figures. (2022). Alzheimer's and Dementia, 18(4), 700–789. https://doi.org/10.1002/alz.12638

American Hospital Association . (2021). 2021 AHA annual survey. American Hospital Association. https://www.ahadata.com/system/files/media/file/2022/11/AHA-Annual-Survey-2021_0.pdf

Assistant Secretary for Planning and evaluation . (2018). National Plan to Address Alzheimer’s Disease. U.S. Department of Health and Human Services. https://aspe.hhs.gov/national-plan-address-alzheimers-disease

Caldwell

J. T.

Ford

C. L.

Wallace

S. P.

Wang

M. C.

Takahashi

L. M.

(2016). Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States. American Journal of Public Health, 106(8), 1463–1469. https://doi.org/10.2105/AJPH.2016.303212

Calkins

M. P.

Kaup

M. L.

Abushousheh

A. M.

(2022). Evaluation of environmental assessment tools for settings for individuals living with dementia. Alzheimer's and Dementia, 8(1), Article e12353. https://doi.org/10.1002/trc2.12353

Chenoweth

Kable

Pond

(2015). Research in hospital discharge procedures addresses gaps in care continuity in the community, but leaves gaping holes for people with dementia: A review of the literature. Australasian Journal on Ageing, 34(1), 9–14. https://doi.org/10.1111/ajag.12205

Curnier

D. Y.

Savage

P. D.

Ades

P. A.

(2005). Geographic distribution of cardiac rehabilitation programs in the United States. Journal of Cardiopulmonary Rehabilitation, 25(2), 80–84. https://doi.org/10.1097/00008483-200503000-00006

Desch

C. E.

Smith

T. J.

Breindel

C. L.

Simonson

C. J.

Kane

(1992). Cancer treatment in rural areas. Hospital & health services administration, 37(4), 449–463.

Fortinsky

R. H.

Downs

(2014). Optimizing person-centered transitions in the dementia journey: A comparison of national dementia strategies. Health Affairs, 33(4), 566–573. https://doi.org/10.1377/hlthaff.2013.1304

10.

Gaugler

J. E.

Bain

L. J.

Mitchell

Finlay

Fazio

Jutkowitz

Alzheimer's Association Psychosocial Measurement Workgroup Banerjee

Butrum

Fazio

Gaugler

Gitlin

Hodgson

Kallmyer

Le Meyer

Logsdon

Maslow

Zimmerman

(2019). Reconsidering frameworks of Alzheimer’s dementia when assessing psychosocial outcomes. Alzheimer's and Dementia, 5(1), 388–397. https://doi.org/10.1016/j.trci.2019.02.008

11.

Ghatak

(2011). A Unique support model for dementia patients and their families in a tertiary hospital setting: Description and preliminary data. Clinical Gerontologist, 34(2), 160–172. https://doi.org/10.1080/07317115.2011.539512

12.

Gibson

Holmes

S. D.

Fields

N. L.

Richardson

V. E.

(2019). Providing care for persons with dementia in rural Communities: Informal caregivers’ perceptions of supports and services. Journal of Gerontological Social Work, 62(6), 630–648. https://doi.org/10.1080/01634372.2019.1636332

13.

Gilmore-Bykovskyi

A. L.

Jin

Gleason

Flowers-Benton

Block

L. M.

Dilworth-Anderson

Barnes

L. L.

Shah

M. N.

Zuelsdorff

(2019). Recruitment and retention of underrepresented populations in Alzheimer’s disease research: A systematic review. Alzheimer’s and Dementia, 5(1), 751–770. https://doi.org/10.1016/j.trci.2019.09.018

14.

Godard-Sebillotte

Le Berre

Schuster

Trottier

Vedel

(2019). Impact of health service interventions on acute hospital use in community-dwelling persons with dementia: A systematic literature review and meta-analysis. PLoS One, 14(6), e0218426. https://doi.org/10.1371/journal.pone.0218426

15.

Gutiérrez

Á.

Cain

Diaz

Aranda

M. P.

(2022). The digital divide exacerbates disparities in Latinx recruitment for Alzheimer’s disease and related dementias online education during COVID-19. Gerontology & Geriatric Medicine, 8, 23337214221081372. https://doi.org/10.1177/23337214221081372

16.

Hebert

L. E.

Weuve

Scherr

Evans

D. A.

Evans

D. A.

(2013). Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology, 80(19), 1778–1783. https://doi.org/10.1212/WNL.0b013e31828726f5

17.

Henein

Arsenault‐Lapierre

Sourial

Godard‐Sebillotte

Vedel

Research on Organization of Healthcare Services for Alzheimer’s (ROSA) Team . (2022). The association between the level of institutional support for dementia care in primary care practices and the quality of dementia primary care: A retrospective chart review. Alzheimer's and Dementia, 8(1). Article e12233, https://doi.org/10.1002/trc2.12233

18.

Hurd

M. D.

Martorell

Delavande

Mullen

K. J.

Langa

K. M.

(2013). Monetary costs of dementia in the United States. New England Journal of Medicine, 368(14), 1326–1334. https://doi.org/10.1056/NEJMsa1204629

19.

Liu

Hlavka

Hillestad

Mattke

(2017). Assessing the preparedness of the U.S. Health care system infrastructure for an Alzheimer’s treatment. RAND Corporation. https://doi.org/10.7249/RR2272

20.

Livingston

Sommerlad

Orgeta

Costafreda

S. G.

Huntley

Ames

Ballard

Banerjee

Burns

Cohen-Mansfield

Cooper

Fox

Gitlin

L. N.

Howard

Kales

H. C.

Larson

E. B.

Ritchie

Rockwood

Sampson

E. L.

Mukadam

(2017). Dementia prevention, intervention, and care. Lancet (London, England), 390(10113), 2673–2734. https://doi.org/10.1016/S0140-6736(17)31363-6

21.

Matthews

K. A.

Gaglioti

A. H.

Holt

J. B.

Croft

J. B.

Mack

McGuire

L. C.

(2019). Racial and ethnic estimates of Alzheimer’s disease and related dementias in the United States (2015–2060) in adults aged ≥65 years. Alzheimer's and Dementia: The Journal of the Alzheimer's Association, 15(1), 17–24. https://doi.org/10.1016/j.jalz.2018.06.3063

22.

Mayeda

E. R.

Glymour

M. M.

Quesenberry

C. P.

Whitmer

R. A.

(2016). Inequalities in dementia incidence between six racial and ethnic groups over 14 years. Alzheimer's and Dementia: The Journal of the Alzheimer's Association, 12(3), 216–224. https://doi.org/10.1016/j.jalz.2015.12.007

23.

Meit

Knudson

Gilbert

A. T. C.

Tanenbaum

Ormson

Popat

(2014). The 2014 update of the rural-urban chartbook. Rural Health Reform Policy Research Center.

24.

National Institute on Aging . (2022). Dementia research and clinical trials: Alzheimer’s disease research centers. National Institutes of Health. https://www.nia.nih.gov/health/alzheimers-disease-research-centers

25.

Rahman

White

E. M.

Mills

Thomas

K. S.

Jutkowitz

(2021). Rural‐urban differences in diagnostic incidence and prevalence of Alzheimer’s disease and related dementias. Alzheimer's and Dementia: The Journal of the Alzheimer's Association, 17(7), 1213–1230. https://doi.org/10.1002/alz.12285

26.

Rajan

K. B.

Weuve

Barnes

L. L.

McAninch

E. A.

Wilson

R. S.

Evans

D. A.

(2021). Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimer's and Dementia: The Journal of the Alzheimer's Association, 17(12), 1966–1975. https://doi.org/10.1002/alz.12362

27.

Resurreccion

D. M.

Motrico

Rigabert

Rubio-Valera

Conejo-Ceron

Pastor

Moreno-Peral

(2017). Barriers for nonparticipation and dropout of women in cardiac rehabilitation programs: A systematic review. Journal of Women's Health, 26(8), 849–859. https://doi.org/10.1089/jwh.2016.6249

28.

Salazar

Dwivedi

A. K.

Royall

D. R.

(2017). Cross-ethnic differences in the severity of neuropsychiatric symptoms in persons with mild cognitive impairment and Alzheimer’s disease. The Journal of neuropsychiatry and clinical neurosciences, 29(1), 13–21. https://doi.org/10.1176/appi.neuropsych.15120423

29.

Sampilo

M. L.

Gutiérrez

Á.

Kamimura-Nishimura

Cavanaugh

Careccia

(2023). The promise of promotores: Building behavioral health equity in the Latino community. Ohio Commission for Hispanic and Latino Affairs. https://ochla.ohio.gov/static/LCR%27s/ThePromiseofPromotores-DIGITAL(2).pdf

30.

StataCorp (2021). Stata statistical Software: Release 17. StataCorp, LLC.

31.

Stepner

(2015). Maptile: Stata module to map a variable. Boston College Department of Economics.

32.

Terada

Oshima

Yokota

Ikeda

Nagao

Takeda

Sasaki

Uchitomi

(2013). Person-centered care and quality of life of patients with dementia in long-term care facilities. Psychiatry Research, 205(1–2), 103–108. https://doi.org/10.1016/j.psychres.2012.08.028

33.

U.S. Department of Agriculture . (2013). Rural-Urban Continuum codes. U.S. Department of Agriculture Economic Research Service. https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/documentation/

34.

Vespa

(2018). The graying of America: More older adults than kids by 2035. United States Census Bureau. https://www.census.gov/library/stories/2018/03/graying-america.html

35.

Vega

W. A.

Rosendez

Jin

(2016). Latinos and Alzheimer’s disease: New numbers behind the Crisis. USC Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s Network.

36.

Ziller

E. C.

Coburn

A. F.

Yousefian

A. E.

(2006). Out-of-pocket health spending and the rural underinsured. Health Affairs, 25(6), 1688–1699. https://doi.org/10.1377/hlthaff.25.6.1688

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.15 MB