P0938 How dementia shapes hospital length-of-stay trajectories in the final years of life

Thaís Barros Pereira da Silva¹, Thales Batista de Souza², Natália Cochar-Soares¹, Sara Souza Lima², Jassiely Priscilla de Faria Santos², Mariane Marques Luiz², Roberta de Oliveira Máximo¹, Andrew Steptoe³, Cesar de Oliveira⁴, Tiago da Silva Alexandre^1,4.

¹Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil, ²Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil, ³Department of Behavioural Science and Health, University College London, London, United Kingdom, ⁴Department of Epidemiology and Public Health, University College London, London, United Kingdom.

INTRODUCTION

Although dementia is rarely recorded as the primary cause of hospital admission, it paradoxically accounts for some of the highest hospital-related costs, largely driven by longer hospital length of stay (LOS), particularly in the final years of life. Despite representing a major public health challenge, evidence on how dementia influences LOS in the final years of life remains scarce. Therefore, we aimed to investigate whether the presence of dementia affects LOS trajectories during the four years preceding death.

METHODS

2,870 participants aged ≥ 60 years

Years prior to the last year of life

Last year of life

Dementia Status

Without dementia

With dementia

According to ICD-10 codes F00-F03 and G30

LOS Trajectories

Total hospital days per follow-up year.

Data from Hospital Episode Statistics (HES)

Generalized linear mixed models, adjusted for socioeconomic and clinical factors, were used to examine retrospective LOS trajectories according to dementia status.

RESULTS

Four years before death, individuals with dementia already presented a higher mean LOS.

16.991 days vs. 24.994 days

Although final-year mean LOS did not differ, the rate of increase in LOS trajectories was significantly different between groups.

0.591 days per year

Annual difference between groups: -2.592 days per year (95% CI: -4.855 to -0.331)

3.183 days per year

CONCLUSION

While inpatient days surge at the very end of life for most older adults, individuals with dementia sustain high LOS burdens years before death. Recognizing these differing trajectories highlights the need for earlier planning of end-of-life care strategies.

thaisbps@estudante.ufscar.br

tiagoalexandre@ufscar.br

Grant Numbers 2023/09037-6 and 2024/02843-0

Attendance at this conference was supported by an AAIC 2026 Conference Fellowship.