Characteristics of community-dwelling people with dementia who had at least 1 visit to the emergency department in Ontario, by COVID-19 pandemic and historical periods (2019–2021)
| Characteristic | No. (%) of people with dementia* | Standardized difference | |
|---|---|---|---|
| Historical period† n = 67 611 | Pandemic period† n = 58 852 | ||
| Age, yr | |||
| Mean ± SD | 81.3 ± 9.7 | 81.4 ± 9.7 | < 0.01 |
| 40–64 | 4219 (6.2) | 3741 (6.4) | 0.01 |
| 65–74 | 9980 (14.8) | 8676 (14.7) | < 0.01 |
| 75–84 | 24 728 (36.6) | 21 421 (36.4) | < 0.01 |
| ≥ 85 | 28 684 (42.4) | 25 014 (42.5) | < 0.01 |
| Sex, female | 38 819 (57.4) | 33 439 (56.8) | 0.01 |
| Rural residence‡ | 7082 (10.5) | 6288 (10.7) | 0.01 |
| Income quintile§ | |||
| 1 (lowest) | 16 368 (24.2) | 14 061 (23.9) | 0.01 |
| 2 | 14 808 (21.9) | 13 011 (22.1) | 0.01 |
| 3 | 13 191 (19.5) | 11 457 (19.5) | < 0.01 |
| 4 | 11 620 (17.2) | 10 198 (17.3) | < 0.01 |
| 5 (highest) | 11 244 (16.6) | 9791 (16.6) | 0 |
| Time since dementia case ascertainment, yr; mean ± SD | 4.1 ± 4.1 | 4.3 ± 4.2 | 0.04 |
| No. of ED visits during the relevant period (includes the first ED visit) | |||
| Mean ± SD | 2.3 ± 2.9 | 2.1 ± 3.3 | 0.06 |
| Median (IQR) | 2 (1–3) | 1 (1–2) | 0.10 |
| 1 | 31 895 (47.2) | 30 253 (51.4) | 0.09 |
| 2 | 16 132 (23.9) | 13 929 (23.7) | 0.01 |
| ≥ 3 | 19 584 (29.0) | 14 670 (24.9) | 0.09 |
| Time in ED, h | |||
| Mean ± SD | 9.6 ± 12.2 | 9.2 ± 10.7 | 0.03 |
| Median (IQR) | 6 (3–10) | 6 (3–10) | 0.03 |
| Discharge disposition | |||
| Discharged home or to place of residence | 37 930 (56.1) | 30 366 (51.6) | 0.09 |
| Admitted to inpatient facility | 20 084 (29.7) | 20 653 (35.1) | 0.12 |
| Transferred to another health care facility | 1394 (2.1) | 1292 (2.2) | 0.01 |
| Transferred to a congregate living facility | 6576 (9.7) | 5681 (9.7) | < 0.01 |
| Left ED | 1595 (2.4) | 822 (1.4) | 0.07 |
| Died | 32 (0.0) | 38 (0.1) | 0.01 |
| No. of chronic conditions at time of visit¶ | |||
| Mean ± SD | 6.1 ± 2.8 | 6.3 ± 2.7 | 0.06 |
| Median (IQR) | 6 (5–8) | 6 (5–8) | 0.04 |
| 0–1 | 5067 (7.5) | 3147 (5.3) | 0.09 |
| 2 | 1329 (2.0) | 1203 (2.0) | 0.01 |
| 3 | 3475 (5.1) | 3077 (5.2) | < 0.01 |
| 4 | 6553 (9.7) | 5777 (9.8) | < 0.01 |
| ≥ 5 | 51 187 (75.7) | 45 648 (77.6) | 0.04 |
| History of specific chronic conditions | |||
| AMI | 5305 (7.8) | 4778 (8.1) | 0.01 |
| Osteoarthritis | 49 007 (72.5) | 43 870 (74.5) | 0.05 |
| Rheumatoid arthritis | 2293 (3.4) | 2076 (3.5) | 0.01 |
| Asthma | 11 487 (17.0) | 10 332 (17.6) | 0.02 |
| Cancer | 39 136 (57.9) | 35 287 (60.0) | 0.04 |
| Cardiac arrhythmia | 15 673 (23.2) | 13 727 (23.3) | < 0.01 |
| Heart failure | 13 629 (20.2) | 12 092 (20.5) | 0.01 |
| Chronic obstructive pulmonary disease | 10 181 (15.1) | 8778 (14.9) | < 0.01 |
| Coronary syndrome (excluding AMI) | 23 983 (35.5) | 20 784 (35.3) | < 0.01 |
| Diabetes | 23 918 (35.4) | 21 468 (36.5) | 0.02 |
| Hypertension | 51 564 (76.3) | 45 728 (77.7) | 0.03 |
| Mood, anxiety, depression and other nonpsychotic disorders | 42 952 (63.5) | 38 261 (65.0) | 0.03 |
| Other mental illnesses | 26 498 (39.2) | 24 437 (41.5) | 0.05 |
| Osteoporosis | 12 256 (18.1) | 10 827 (18.4) | 0.01 |
| Renal failure | 13 205 (19.5) | 12 387 (21.0) | 0.04 |
| Stroke (excluding transient ischemic attack) | 10 330 (15.3) | 8976 (15.3) | < 0.01 |
Note: AMI = acute myocardial infarction, ED = emergency department, IQR = interquartile range, SD = standard deviation.
↵* Unless indicated otherwise.
↵† Historical period: week of Mar. 3, 2019, to the week of Feb. 23, 2020. COVID-19 pandemic period: week of Mar. 1, 2020, to the week of Feb. 21, 2021. For people who visited the ED more than once in a given period, characteristics shown are as of the first visit in each period.
↵‡ We defined rural residence as having a Rurality Index for Ontario value greater than 40.
↵§ We defined neighbourhood income quintiles using postal code linkage to Statistics Canada Census data (2016; https://www150.statcan.gc.ca/n1/pub/92-154-g/92-154-g2017001-eng.htm).
↵¶ We used Mondor et al.20 to define a history of chronic conditions. Eligible conditions included AMI, osteoarthritis, rheumatoid arthritis, asthma, cancer, cardiac arrhythmia, heart failure, chronic obstructive pulmonary disease, coronary syndrome (excluding AMI), dementia, diabetes, hypertension, mood, anxiety, depression and other nonpsychotic disorders, other mental illnesses, osteoporosis, renal failure and stroke (excluding transient ischemic attack).