# Glucose Levels and Preventable Hospitalizations in Alzheimer and Diabetes

> **NIH NIH R03** · UNIVERSITY OF WASHINGTON · 2020 · $79,249

## Abstract

As people in the US live longer, persons with comorbid Alzheimer disease or related dementias (hereafter
dementia) and diabetes become increasingly common in clinical care. Diabetes is a largely ambulatory and
self-managed condition that should not require inpatient care. Persons living with dementia and diabetes
(PWD&D), however, have high risks of hospitalizations. These hospitalizations are considered preventable and
potentially avoidable. There is a need to understand care considerations in PWD&D that predispose them to
potentially preventable hospitalizations (PPH), and this has been articulated as an important national goal. In
diabetes, glycemic control has been fundamental in clinical care as it reduces risks of diabetes complications.
Older adults with diabetes, in particular those with cognitive deficits, however, may have difficulty managing
glucose at home and therefore have higher rates of diabetes complications. PWD&D are also susceptible to
overtreatment and have increased health care utilization because of hypoglycemia. Therefore, both the risks of
diabetes complications and the risks of therapy (e.g., hypoglycemia) should be considered when setting
therapeutic goals. However, the most appropriate glycemic targets for these patients have not been empirically
determined. The AGS and ADA have promulgated recommendations on optimal glucose targets in persons
with cognitive impairment, but these are consensus statements and should be strengthened through higher
levels of evidence. To our knowledge, no prior prospective study with research standards for dementia
diagnosis has evaluated the implications of incident dementia for glucose control among people with diabetes
and, particularly in terms of rates of hospitalizations, PPH, and diabetes-related PPH. We propose to examine
the relationship between dementia onset, glucose levels, and rates of different types of hospitalizations in
people with diabetes from the NIA-funded Adult Changes in Thought (ACT) study. ACT resources include
extensive clinical laboratory data, incident research-quality dementia diagnoses and complete capture of
hospitalization and medication data. Our first aim will be to determine the extent to which dementia onset is
associated with higher rates of overall hospitalizations, rates of PPH and rates of diabetes-related PPH among
persons with treated diabetes. Our second aim will be to evaluate the association of average time-varying
individual-level glucose levels with the rates of overall hospitalization, PPH, and diabetes-related PPH while
accounting for incident dementia and other time-varying confounders. By leveraging ACT, the proposed study
provides an extraordinary opportunity for new observational insights into the associations among dementia,
glucose control and hospitalizations in older persons with diabetes. Findings from this study address national
priority and will advance our understanding of the role of glycemic control on admission risks in an
un...

## Key facts

- **NIH application ID:** 9849715
- **Project number:** 5R03AG061305-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Oleg Zaslavsky
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $79,249
- **Award type:** 5
- **Project period:** 2019-01-15 → 2020-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9849715

## Citation

> US National Institutes of Health, RePORTER application 9849715, Glucose Levels and Preventable Hospitalizations in Alzheimer and Diabetes (5R03AG061305-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9849715. Licensed CC0.

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