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Factors Associated With Psychiatric Hospitalization of Individuals Diagnosed With Dementia and Comorbid Bipolar Disorder

Palo Alto Veterans Affairs Health Care System, Palo Alto, California, and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, john-brooks{at}stanford.edu

Jennifer C. Hoblyn, MD, MPH

Palo Alto Veterans Affairs Health Care System, Palo Alto, California, and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

Helena Chmura Kraemer, PhD

Palo Alto Veterans Affairs Health Care System, Palo Alto, California, and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

Jerome A. Yesavage, MD

Palo Alto Veterans Affairs Health Care System, Palo Alto, California, and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

The objective was to determine risk factors of psychiatric hospitalization among a Veterans Administration database of patients with dementia and comorbid bipolar disorder (D+BD). Patients with D+BD had a greater prevalence of psychiatric hospitalization (28% vs 4%). The strongest predictor of psychiatric hospitalization was the presence of an alcohol use disorder (51% risk); patients without alcohol use disorders but under the age of 70 had the next highest risk (33% risk). However, patients with an alcohol use disorder had shorter psychiatric hospitalizations than those without. Compared with patients without BD, D+BD patients were more likely to have alcohol use disorders (15% vs 3%) and any other substance use problem (10% vs 1%). In patients diagnosed with dementia and bipolar disorder, the strongest risk factor for psychiatric hospitalization was an alcohol abuse disorder. These findings suggest that disorders with increased frequency in BD affect the course of dementia.

Key Words: bipolar disorder • dementia • Alzheimer’s disease • substance abuse

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