Incident Dementia, Glycated Hemoglobin (HbA1c) Levels and Potentially Preventable Hospitalizations in People Age 65 and Older with Diabetes.

BACKGROUND To determine whether incident dementia and HbA1c levels are associated with increased rates of potentially preventable hospitalizations (PPH) in persons with diabetes. METHODS 565 adults age 65+ ever treated for diabetes were from ACT study. PPH were from principal discharge diagnoses and included diabetes PPH (dPPH), respiratory PPH (rPPH), urinovolemic PPH (uPPH), cardiovascular, and other PPH. Poisson generalized estimating equations estimated rate ratios (RR) and 95% confidence intervals (CI) for the associations between dementia or HbA1c measures and rate of PPH. RESULTS 562 individuals contributed 3602 dementia-free years, and 132 individuals contributed 511 dementia follow-up years. 128 (23%) dementia-free individuals had 210 PPH admissions and a crude rate of 58 per 1000 person-years while 55 (42%) individuals with dementia had 93 PPH admissions, a rate of 182 per 1000 person-years. The adjusted RR (95% CI) comparing rates between dementia and dementia-free groups were 2.27 (1.60, 3.21) for overall PPH; 5.90 (2.70, 12.88) for dPPH; 5.17 (2.49, 10.73) for uPPH, and 2.01 (1.06, 3.83) for rPPH. Compared with HbA1c of 7-8% and adjusted for dementia, the RR (95% CI) for overall PPH was 1.43 (1.00, 2.06) for >8% and 1.18 (0.85, 1.65) for 8% and 8% vs. lower levels are associated with higher rates of overall, UTI and dehydration-related PPHs.