A systematic review of intervention studies to prevent hospitalizations of community-dwelling older adults with dementia

Med Care. 2015 Feb;53(2):207-13. doi: 10.1097/MLR.0000000000000294.


Objectives: To conduct a systematic literature review to determine if there were any intervention strategies that had any measurable effect on acute-care hospitalizations among community-dwelling adults with dementia.

Design: Studies were identified by a professional research librarian and content experts.

Setting: Community dwelling.

Participants: Participants were diagnosed with dementia, severity ranging from mild to severe, and were recruited from health care and community agencies.

Measurements: A study met the inclusion criteria if it: (a) was published in English; (b) included a control or comparison group; (c) published outcome data from the intervention under study; (d) reported hospitalization as one of the outcomes; (e) included community-dwelling older adults; and (f) enrolled participants with dementia. Ten studies met all inclusion criteria.

Results: Of the 10 studies included, most assessed health services use (ie, hospitalizations) as a secondary outcome. Participants were recruited from a range of health care and community agencies, and most were diagnosed with dementia with severity ratings ranging from mild to severe. Most intervention strategies consisted of face-to-face assessments of the persons living with dementia, their caregivers, and the development and implementation of a care plan. A significant reduction in hospital admissions was not found in any of the included studies, although 1 study did observe a reduction in hospital days.

Conclusions: The majority of studies included hospitalizations as a secondary outcome. Only 1 intervention was found to have an effect on hospitalizations. Future work would benefit from strategies specifically designed to reduce and prevent acute hospitalizations in persons with dementia.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dementia / rehabilitation*
  • Female
  • Homes for the Aged / organization & administration*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Nursing Homes / organization & administration*
  • Outcome Assessment, Health Care
  • Patient Care Management / organization & administration*