BACKGROUND Little is known about the patterns of end-of-life health care for older Mexican Americans with or without a diagnosis of Alzheimer's disease and related dementias (ADRD). Our objective was to investigate the frequency of acute hospital admissions, intensive care unit use, and ventilator use during the last 30 days of life for deceased older Mexican American Medicare beneficiaries with and without an ADRD diagnosis. METHODS We used Medicare claims data linked with survey information from 1,090 participants (mean age of death 85.1 years) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly. Multivariable logistic regression models were used to estimate the odds for hospitalization, intensive care unit use, and ventilator use in the last 30 days of life for decedents with ADRD than those without ADRD. Generalized linear models were used to estimate the risk ratio (RR) for length of stay in hospital. RESULTS Within the last 30 days of life, 64.5% decedents had an acute hospitalization (59.1% ADRD, 68.3% no ADRD), 33.9% had an intensive care unit stay (31.3% ADRD, 35.8% no ADRD), and 17.2% used a ventilator (14.9% ADRD, 18.8% no ADRD). ADRD was associated with significantly lower hospitalizations (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.50-0.89) and shorter length of stay in hospital (RR = 0.77, 95% CI = 0.65-0.90). CONCLUSION Hospitalization, intensive care unit stay, and ventilator use are common at the end of life for older Mexican Americans. The lower hospitalization and shorter length of stay in hospital of decedents with ADRD indicate a modest reduction in acute care use. Future research should investigate the impact of end-of-life planning on acute-care use and quality of life in terminally ill Mexican American older adults.

中文翻译：

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患有或未诊断出阿尔茨海默病和相关痴呆症的老年墨西哥裔美国人的临终医疗保健利用情况。


背景技术对于患有或未诊断出阿尔茨海默病及相关痴呆（ADRD）的老年墨西哥裔美国人的临终医疗保健模式知之甚少。我们的目的是调查已故老年墨西哥裔美国医疗保险受益人（有或没有 ADRD 诊断）在生命最后 30 天内急性入院、重症监护病房使用和呼吸机使用的频率。方法 我们使用 Medicare 索赔数据和来自 1,090 名西班牙裔既定人群（平均死亡年龄 85.1 岁）的调查信息进行老年人流行病学研究。使用多变量逻辑回归模型来估计患有 ADRD 的死者与无 ADRD 的死者相比，在生命的最后 30 天内住院、使用重症监护病房和使用呼吸机的几率。使用广义线性模型来估计住院时间的风险比（RR）。结果 在生命的最后 30 天内，64.5% 的死者曾急性住院（59.1% ADRD，68.3% 无 ADRD），33.9% 曾住过重症监护室（31.3% ADRD，35.8% 无 ADRD），17.2% 曾使用过呼吸机（14.9% ADRD，18.8% 无 ADRD）。 ADRD 与显着较低的住院率（比值比 [OR] = 0.67，95% 置信区间 [CI] = 0.50-0.89）和较短的住院时间（RR = 0.77，95% CI = 0.65-0.90）相关。结论 对于老年墨西哥裔美国人来说，临终时住院、入住重症监护室和使用呼吸机很常见。 ADRD 死者的住院率较低，住院时间较短，表明急性护理使用量略有减少。 未来的研究应该调查临终规划对身患绝症的墨西哥裔美国老年人的急症护理使用和生活质量的影响。