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Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes.
Am J Geriatr Psychiatry. 2004 Nov-Dec; 12(6):639-47.AJ

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.

Authors+Show Affiliations

Division of Geriatric Medicine, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15545332

Citation

Joray, Sabine, et al. "Cognitive Impairment in Elderly Medical Inpatients: Detection and Associated Six-month Outcomes." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 12, no. 6, 2004, pp. 639-47.
Joray S, Wietlisbach V, Büla CJ. Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes. Am J Geriatr Psychiatry. 2004;12(6):639-47.
Joray, S., Wietlisbach, V., & Büla, C. J. (2004). Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 12(6), 639-47.
Joray S, Wietlisbach V, Büla CJ. Cognitive Impairment in Elderly Medical Inpatients: Detection and Associated Six-month Outcomes. Am J Geriatr Psychiatry. 2004 Nov-Dec;12(6):639-47. PubMed PMID: 15545332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes. AU - Joray,Sabine, AU - Wietlisbach,Vincent, AU - Büla,Christophe J, PY - 2004/11/17/pubmed PY - 2005/3/1/medline PY - 2004/11/17/entrez SP - 639 EP - 47 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 12 IS - 6 N2 - 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. SN - 1064-7481 UR - https://www.unboundmedicine.com/medline/citation/15545332/Cognitive_impairment_in_elderly_medical_inpatients:_detection_and_associated_six_month_outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/12/6/639 DB - PRIME DP - Unbound Medicine ER -