{"id":23533,"date":"2026-04-09T13:02:49","date_gmt":"2026-04-09T17:02:49","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=23533"},"modified":"2026-04-14T13:07:29","modified_gmt":"2026-04-14T17:07:29","slug":"evaluating-the-joint-effects-of-dementia-and-frailty-on-burdensome-transitions-among-long-term-care-residents-in-ontario-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/evaluating-the-joint-effects-of-dementia-and-frailty-on-burdensome-transitions-among-long-term-care-residents-in-ontario-canada\/","title":{"rendered":"Evaluating the joint effects of dementia and frailty on burdensome transitions among long-term care residents in Ontario, Canada"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Transfers from long-term care (LTC) to hospital near the end of life can be burdensome for LTC residents. Dementia and frailty are common in this population, yet their relationship to burdensome transitions remains unclear. This study examined the joint associations between dementia, frailty, and end-of-life burdensome transitions among LTC residents.<\/p>\n<p><strong>Methods<\/strong> \u2014 We conducted a population-based retrospective cohort study using health administrative data, capturing LTC residents aged \u2265\u200965 who died in Ontario, Canada, January 1, 2015\u2013March 31, 2020. Dementia was identified using a validated algorithm, supplemented with Resident Assessment Instrument\u2014Minimum Dataset 2.0 (RAI-MDS) data. Frailty (non-frail, pre-frail, frail) was assessed using a 72-item frailty index developed for use with the RAI-MDS. Burdensome transitions were defined as 3+ transfers to hospital (\u2265\u20092 if due to pneumonia, urinary tract infection, sepsis, dehydration) in the last 90\u2009days of life (last 180\u2009days as secondary outcome). Poisson regression was used to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs) for burdensome transitions by dementia and frailty status.<\/p>\n<p><strong>Results<\/strong> \u2014 Among 88,507 LTC decedents, most were frail (67.6%) and had dementia (87.5%). Approximately 4.7% of residents experienced a burdensome transition in the last 90\u2009days of life (8.8% in the last 180\u2009days). Dementia was associated with a reduced risk of burdensome transitions in the last 90\u2009days of life across frailty strata (non-frail: RR\u2009=\u20090.77, 95% CI, 0.64\u20130.92; pre-frail: RR\u2009=\u20090.86, 95% CI, 0.77\u20130.97; frail: RR\u2009=\u20090.79, 95% CI, 0.71\u20130.89). Similar findings were observed when examining burdensome transitions in the last 180\u2009days of life.<\/p>\n<p><strong>Conclusion<\/strong> \u2014 Dementia and frailty are independently associated with a lower likelihood of burdensome transitions near the end of life in LTC residents. Further research is needed to explore the appropriateness of hospital transfers at the end of life, considering the perspectives of LTC residents, family, and healthcare providers.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Transfers from long-term care (LTC) to hospital near the end of life can be burdensome for LTC residents. Dementia and frailty are common in this population, yet their relationship to burdensome transitions remains unclear. This study examined the joint associations between dementia, frailty, and end-of-life burdensome transitions among LTC residents. Methods \u2014 We [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[41,32,51],"migration-helper-qa-sample-set":[],"class_list":["post-23533","journal_article","type-journal_article","status-publish","hentry","topic-brain-diseases","topic-long-term-care-and-continuing-care","topic-musculoskeletal-diseases-and-disorders"],"acf":{"citation":"Webber C, Konikoff L, Li W, Grubic N, Maxwell CJ, Bush SH, Casey G, Isenberg SR, Tanuseputro P, Qureshi D. <em>J Am Geriatr Soc<\/em>. 2026; Apr 9 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1111\/jgs.70418","ices_scientist":[1322,1274],"site":[6734],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Evaluating the joint effects of dementia and frailty on burdensome transitions among long-term care residents in Ontario, Canada<\/title>\n<meta name=\"description\" content=\"Background \u2014 Transfers from long-term care (LTC) to hospital near the end of life can be burdensome for LTC residents. 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