Abstracts

Rationale: Current evidence points to a bi-directional relationship between epilepsy and ADRD, with both conditions increasing risks of hospitalization. However, comprehensive information on hospitalization patterns and risk factors in patients with co-morbid ADRD and epilepsy remain limited.

Methods: We analyzed hospital discharge data from four states (NY, WI, MD, FL) for patients aged > 65 years with ADRD (n = 707,531) and ADRD+epilepsy (n = 43,209). We modeled inpatient hospitalization rates using negative binomial regression, adjusting for demographics, insurance status, income quartile, sex, state of residence, and Elixhauser co-morbidity index. We also examined length of stay (LOS) as a secondary outcome.

Results: Patients with ADRD+epilepsy demonstrated significantly higher inpatient hospitalization rates (rate ratio [RR] 1.10, 95% CI: 1.08-1.12), with more annual hospital visits (1.5 per year, versus 1.4 for ADRD alone, p < 0.0001). The ADRD+epilepsy group also had a longer mean LOS (7.8 versus 6.6 days, p < 0.0001) compared to ADRD alone. Racial disparities were striking, with Black patients representing 23.6% of the ADRD+epilepsy cohort versus 12.6% of ADRD alone (p < 0.0001) and showing the highest risk of hospitalization (RR 1.24, 95% CI: 1.23-1.25, versus White patients). Hispanic/Latino patients also had higher risks of hospitalization (RR 1.22, 95% CI: 1.21-1.23). Similarly, public insurance under Medicare (RR 1.24, 95% CI: 1.20-1.28) and Medicaid (RR 1.10, 95% CI: 1.05-1.16) was associated with higher admission rates when compared with private insurance.