OBJECTIVES: Comorbidity profiles of patients with dementia-related psychosis (DRP) in US long-term care (LTC) skilled nursing facilities were compared with the comorbidity burden of No DRP patients or patients with dementia-related agitation/aggression (DAA). There are no prior real-world published studies comparing the burden of disease among these three groups.

METHODS: Dementia patients were identified with ≥2 diagnosis codes for dementia or 1 dementia diagnosis code and prescription of antidementia therapy during 01/01/2013 to 05/30/2017. Patients were categorized into DRP, No DRP, and DAA groups (index date). DRP: ≥2 psychosis diagnosis codes, or 1 psychosis diagnosis code and prescription of anti-psychotic (AP) therapy; No DRP: no psychosis diagnosis and no history of AP therapy; DAA: ≥2 diagnosis codes of agitation or aggression, no history of psychosis diagnosis and AP therapy. Comorbidities were defined during 12 months prior to index date to assess concomitant comorbidity burden. Unadjusted descriptive statistics analyses were conducted comparing No DRP versus DRP and No DRP versus DAA.

RESULTS: There were 68,743 dementia residents: No DRP (n=41,438; 60%), DRP (n=20,981; 30%), DAA (n=6324; 9%). DRP patients were younger (mean age 79 years) versus No DRP (84 years) or DAA (83 years). DRP patients were sicker overall versus No DRP: anxiety (52% versus 26%); bladder disorders (13% versus 6%); depression (70% versus 46%); hypertension (32% versus 17%); heart conditions (9% versus 5%); insomnia disorders (29% versus 15%); (all P<0.05). More DAA patients had anxiety (36%), bladder disorders (12%), depression (56%), hypertension (31%), and insomnia disorders (21%) compared with No DRP group (all P<0.05).

CONCLUSIONS: The comorbidity burden associated with DRP or DAA is greater than No DRP. This is the first study to use a national US-LTC database, which provides real-world comorbidity burden for DRP. Further analyses are being conducted to better understand the factors that may impact treatment choices between these groups.