With Alzheimer's, hospital stay can be risk

WASHINGTON -- For people with Alzheimer's disease, a hospital stay may prove catastrophic.

Those with dementia are far more likely to be hospitalized than other older adults, often for preventable reasons like an infection that wasn't noticed early enough. Hospitals can be upsetting to anyone, but consider the added fear factor if you can't remember where you are or why strangers keep poking you.

Now a new study highlights the lingering ill effects: Being hospitalized seems to increase the chances of Alzheimer's patients moving into a nursing home, or even dying, within the next year, Harvard researchers reported yesterday. The risk is higher if patients experience what's called delirium, a state of extra confusion and agitation, during their stay.

The experts agree that caregivers need to know the risk of delirium so they can help a loved one with dementia avoid the hospital if at all possible.

"It's a very stressful time, being in the hospital," says lead researcher Dr. Tamara Fong, of the Harvard-affiliated Beth Israel Deaconess Hospital and Hebrew SeniorLife in Boston. Often families tell her, "Dad was never the same after he had that surgery and he was confused."

It's a challenge even for health professionals. Psychiatrist Leslie Fuchs watched in disbelief as her mother, who'd had slowly worsening Alzheimer's for several years, rapidly disintegrated during a stay in a New York City hospital.

Relatives had called 911 when Thelma Fuchs, 79, had what appeared to be a brief seizure. That problem cleared up, but the hospital was reluctant to discharge her with it unexplained. Over a few days, Fuchs became increasingly distraught, and wound up being prescribed antipsychotic drugs, her daughter recalls. Later, at home, she calmed down and no longer needed the medications.

In the survey, of those who survived the initial hospitalization, 9 percent died in the following year, as did 15 percent of those who'd suffered delirium, Fong reported Monday in the journal Annals of Internal Medicine.