Dementia and intentional and unintentional poisoning in older people: a 10 year review of hospitalization records in New South Wales, Australia

Rebecca J. Mitchell, Lara A. Harvey, Henry Brodaty, Brian Draper, Jacqueline C T Close

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Background: Medicinal substances have been identified as common agents of both unintentional and intentional poisoning among older people, including those with dementia. This study aims to compare the characteristics of poisoning resulting in hospitalization in older people with and without dementia and their clinical outcomes. Methods: A retrospective cohort study involving an examination of poisoning by intent involving individuals aged 50+ years with and without dementia using linked hospitalization and mortality records during 2003-2012. Individuals who had dementia were identified from hospital diagnoses and unintentional and intentional poisoning was identified using external cause classifications. The epidemiological profile (i.e. individual and incident characteristics) of poisoning by intent and dementia status was compared, along with clinical outcomes of hospital length of stay (LOS), 28-day readmission and 30-day mortality. Results: The hospitalization rate for unintentional and intentional poisoning for individuals with dementia was double and 1.5 times higher than the rates for individuals without dementia (69.5 and 31.6 per 100,000) and (56.4 and 32.5 per 1,00,000). The home was the most common location of poisoning. Unintentional poisoning was more likely to involve individuals residing in aged care facilities (OR 2.12; 95%CI 1.70-2.63) or health service facilities (OR 3.91; 95%CI 3.45-4.42). There were higher mortality rates and longer LOS for unintentional poisoning for individuals with dementia. Conclusions: Clinicians need to be aware of the risks of poisoning for individuals with dementia and care is required in appropriate prescription, safe administration, and potential for self-harm with commonly used medications, such as anticholinesterase medications, antihypertensive drugs, and laxatives.

LanguageEnglish
Pages1757-1768
Number of pages12
JournalInternational Psychogeriatrics
Volume27
Issue number11
DOIs
Publication statusPublished - 1 Nov 2015

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South Australia
New South Wales
Poisoning
Dementia
Hospitalization
Length of Stay
Mortality
Laxatives
Health Facilities
Cholinesterase Inhibitors
Antihypertensive Agents
Health Services
Prescriptions
Cohort Studies
Retrospective Studies

Bibliographical note

Corrigendum can be found at International Psychogeriatrics volume 27(12), p2101, https://doi.org/10.1017/S1041610215001581

Keywords

  • dementia
  • poisoning
  • intention
  • hospitalization
  • death

Cite this

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title = "Dementia and intentional and unintentional poisoning in older people: a 10 year review of hospitalization records in New South Wales, Australia",
abstract = "Background: Medicinal substances have been identified as common agents of both unintentional and intentional poisoning among older people, including those with dementia. This study aims to compare the characteristics of poisoning resulting in hospitalization in older people with and without dementia and their clinical outcomes. Methods: A retrospective cohort study involving an examination of poisoning by intent involving individuals aged 50+ years with and without dementia using linked hospitalization and mortality records during 2003-2012. Individuals who had dementia were identified from hospital diagnoses and unintentional and intentional poisoning was identified using external cause classifications. The epidemiological profile (i.e. individual and incident characteristics) of poisoning by intent and dementia status was compared, along with clinical outcomes of hospital length of stay (LOS), 28-day readmission and 30-day mortality. Results: The hospitalization rate for unintentional and intentional poisoning for individuals with dementia was double and 1.5 times higher than the rates for individuals without dementia (69.5 and 31.6 per 100,000) and (56.4 and 32.5 per 1,00,000). The home was the most common location of poisoning. Unintentional poisoning was more likely to involve individuals residing in aged care facilities (OR 2.12; 95{\%}CI 1.70-2.63) or health service facilities (OR 3.91; 95{\%}CI 3.45-4.42). There were higher mortality rates and longer LOS for unintentional poisoning for individuals with dementia. Conclusions: Clinicians need to be aware of the risks of poisoning for individuals with dementia and care is required in appropriate prescription, safe administration, and potential for self-harm with commonly used medications, such as anticholinesterase medications, antihypertensive drugs, and laxatives.",
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Dementia and intentional and unintentional poisoning in older people : a 10 year review of hospitalization records in New South Wales, Australia. / Mitchell, Rebecca J.; Harvey, Lara A.; Brodaty, Henry; Draper, Brian; Close, Jacqueline C T.

In: International Psychogeriatrics, Vol. 27, No. 11, 01.11.2015, p. 1757-1768.

Research output: Contribution to journalReview articleResearchpeer-review

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T1 - Dementia and intentional and unintentional poisoning in older people

T2 - International Psychogeriatrics

AU - Mitchell, Rebecca J.

AU - Harvey, Lara A.

AU - Brodaty, Henry

AU - Draper, Brian

AU - Close, Jacqueline C T

N1 - Corrigendum can be found at International Psychogeriatrics volume 27(12), p2101, https://doi.org/10.1017/S1041610215001581

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background: Medicinal substances have been identified as common agents of both unintentional and intentional poisoning among older people, including those with dementia. This study aims to compare the characteristics of poisoning resulting in hospitalization in older people with and without dementia and their clinical outcomes. Methods: A retrospective cohort study involving an examination of poisoning by intent involving individuals aged 50+ years with and without dementia using linked hospitalization and mortality records during 2003-2012. Individuals who had dementia were identified from hospital diagnoses and unintentional and intentional poisoning was identified using external cause classifications. The epidemiological profile (i.e. individual and incident characteristics) of poisoning by intent and dementia status was compared, along with clinical outcomes of hospital length of stay (LOS), 28-day readmission and 30-day mortality. Results: The hospitalization rate for unintentional and intentional poisoning for individuals with dementia was double and 1.5 times higher than the rates for individuals without dementia (69.5 and 31.6 per 100,000) and (56.4 and 32.5 per 1,00,000). The home was the most common location of poisoning. Unintentional poisoning was more likely to involve individuals residing in aged care facilities (OR 2.12; 95%CI 1.70-2.63) or health service facilities (OR 3.91; 95%CI 3.45-4.42). There were higher mortality rates and longer LOS for unintentional poisoning for individuals with dementia. Conclusions: Clinicians need to be aware of the risks of poisoning for individuals with dementia and care is required in appropriate prescription, safe administration, and potential for self-harm with commonly used medications, such as anticholinesterase medications, antihypertensive drugs, and laxatives.

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