Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

Development of a clinical prediction model for delirium or dementia-related hospitalisation risk after residential aged care entry: using linked population-based aged care and health care data (#266)

Tesfahun C Eshetie 1 2 3 , Gillian E Caughey 1 2 3 , Catherine Lang 1 2 , Craig Whitehead 4 5 , Maria Crotty 4 5 , Megan Corlis 6 , Renuka Visvanathan 7 8 , Maria C Inacio 1 2 3
  1. Registry of Senior Australians (ROSA) Research Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
  2. Registry of Senior Australians (ROSA) Research Centre, Caring Futures Institute, Flinders University , Adelaide, SA, Australia
  3. School of Allied Health and Human Performance, College of Health, Adelaide University, Adelaide, SA, Australia
  4. College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
  5. Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
  6. Australian Nursing and Midwifery Federation (SA Branch), Adelaide, SA, Australia
  7. Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, College of Health, School of Medicine, Adelaide University, Adelaide, SA, Australia
  8. Aged and Extended Care Services, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Research, Central Adelaide Local Health Network, SA Health, Adelaide, SA, Australia

Aims: To identify predictors of delirium or dementia-related hospitalisation risk within 365 days of residential aged care facility (RACF) entry and develop a risk prediction model for new residents.

Methods: Using the Registry of Senior Australians (ROSA) Historical National Cohort, non-indigenous individuals living with dementia aged ≥65 years old who entered 2,655 RACFs between 01/01/2009-31/12/2018 in four Australian states were included (N=207,343). Delirium or dementia-related hospitalisation was ascertained from hospitalisation or emergency department (ED) presentation records within 365 days of RACF entry. Individual, medication, facility, system and health care-related factors were examined as predictors. An elastic net penalised regression and Fine-Gray model was used. Model discrimination was examined using the area under the receiver operating characteristics curve (AUC).

Results: Within 365 days of RACF entry, 5.2% (N=10,709) of individuals living with dementia had a delirium or dementia-related hospitalisations. The strongest predictors of delirium or dementia related hospitalisations were: history of ED presentation (≥5 vs none, sub-distribution hazard ratio (sHR)=1.65, 95% confidence interval (CI) 1.47-1.84), history of physical violence (sHR=1.64, 95%CI 1.30-2.06), being male (sHR=1.57, 95%CI 1.49-1.65), history of delirium (sHR=1.48, 95%CI 1.38-1.60), use of Monoamine Oxidase B inhibitor (sHR=1.43, 95%CI 1.07-1.90), and use of dipeptidyl peptidase 4 inhibitor medications (sHR=1.34, 95%CI 1.15-1.55). The model AUC (testing cohort) was 0.66, 95%CI 0.650-0.68.

Conclusions: Routinely collected aged care and health care data following RACF entry can moderately inform risk profiling for delirium or dementia-related hospitalisations in individuals with dementia. Our prediction model could support targeted interventions to reduce such hospitalisations in RACFs.