American Geriatric Society
Amber E. Barnato, John D. Birkmeyer, Jonathan S. Skinner, A. James O’Malley, Nancy J. O. Birkmeyer
Background: We sought to determine whether dementia is associated with treatment intensity and
mortality in patients hospitalized with COVID-19.
Methods: Review of the medical records for patients > 60 years of age (n=5,394) hospitalized with
COVID-19 from 132 community hospitals between March and June, 2020. We examined the
relationships between dementia and treatment intensity (including intensive care unit admission (ICU)
and mechanical ventilation (MV) and care processes that may influence them, including advance care
planning (ACP) billing and do-not-resuscitate (DNR) orders) and in-hospital mortality adjusting for age,
sex, race/ethnicity, comorbidity, month of hospitalization, and clustering within hospital. We further
explored the effect of ACP conversations on the relationship between dementia and outcomes, both at
the individual patient level (effect of having ACP) and at the hospital level (effect of being treated at a
hospital with low: <10%, medium 10-20%, or high >20% ACP rates)…