Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes.

Details

Serval ID
serval:BIB_CDD134A7B802
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes.
Journal
The American Journal of Geriatric Psychiatry
Author(s)
Joray S., Wietlisbach V., Büla C.J.
ISSN
1064-7481
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
12
Number
6
Pages
639-647
Language
english
Abstract
OBJECTIVE: The authors examined the relationship of cognitive impairment at hospital admission to 6-month outcome (hospital readmission, nursing home admission, and death) in a cohort of elderly medical inpatients. METHODS: A group of 401 medical inpatients age 75 and older underwent a comprehensive geriatric assessment at hospital admission and were followed up for 6 months. Cognitive impairment was defined as a score <24 on the Mini-Mental State Exam. Detection was assessed through blinded review of discharge summary. Follow-up data were gathered from the centralized billing system (hospital and nursing home admissions) and from proxies (death). RESULTS: Cognitive impairment was present in 129 patients (32.3%). Only 48 (37.2%) were detected; these had more severe impairment than undetected cases. During follow-up, cognitive impairment, whether detected or not, was associated with death and nursing home admission. After adjustment for health, functional, and socioeconomic status, an independent association remained only for nursing home admission in subjects with detected impairment. Those with undetected impairment appeared to be at intermediate risk, but this relationship was not statistically significant. CONCLUSION: In these elderly medical inpatients, cognitive impairment was frequent, rarely detected, and associated with nursing home admission during follow-up. Although this association was stronger in those with detected impairment, these results support the view that acute hospitalization presents an opportunity to better detect cognitive impairment in elderly patients and target further interventions to prevent adverse outcomes such as nursing home admission.
Keywords
Activities of Daily Living, Aged, Aged, 80 and over, Cognition Disorders, Disability Evaluation, Female, Follow-Up Studies, Geriatric Assessment, Homes for the Aged, Humans, Male, Mental Status Schedule, Nursing Homes, Outcome Assessment (Health Care), Patient Admission, Patient Readmission, Psychometrics, Survival Analysis
Pubmed
Web of science
Create date
05/03/2008 15:56
Last modification date
20/08/2019 15:48
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