Associations Between Mild Cognitive Impairment and Hospitalization and Readmission
- PMID: 26313420
- PMCID: PMC4809245
- DOI: 10.1111/jgs.13593
Associations Between Mild Cognitive Impairment and Hospitalization and Readmission
Abstract
Objectives: To determine whether older adults with mild cognitive impairment (MCI), a condition not previously explored as a risk factor, have more hospitalizations and 30-day readmissions than those with normal cognition.
Design: Post hoc analysis of prospectively gathered data on incident hospitalization and readmission from the Ginkgo Evaluation of Memory Study (GEMS), a randomized, double-blind, placebo-controlled trial designed to assess the effect of Ginkgo biloba on incidence of dementia.
Setting: GEMS was conducted in five academic medical centers in the United States.
Participants: Community-dwelling adults aged 75 and older with normal cognition (n = 2,314) or MCI (n = 428) at baseline cognitive testing (N = 2,742).
Measurements: Index hospitalization and 30-day hospital readmission, adjusted for age, sex, race, education, clinic site, trial assignment status, comorbidities, number of prescription medications, and living with an identified proxy.
Results: MCI was associated with a 17% greater risk of index hospitalization than normal cognition (adjusted hazard ratio (aHR) = 1.17, 95% confidence interval (CI) = 1.02-1.34)). In participants who lived with a proxy, MCI was associated with a 39% greater risk of index hospitalization (aHR = 1.39, 95% CI = 1.17-1.66). Baseline MCI was not associated with greater odds of 30-day hospital readmission (adjusted odds ratio = 0.90, 95% CI = 0.60-1.36).
Conclusion: MCI may represent a target condition for healthcare providers to coordinate support services in an effort to reduce hospitalization and subsequent disability.
Keywords: acute hospital utilization; mild cognitive impairment; rehospitalization.
© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.
Conflict of interest statement
Conflict of Interest Checklist: [Table: see text]
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References
-
- Agency for Healthcare Research and Quality. Healthcare cost and utilization project facts and figures. 2008
-
- Williams MV. A requirement to reduce readmissions: take care of the patient, not just the disease. JAMA. 2013;309:394–396. - PubMed
-
- Kocher RP, Adashi EY. Hospital readmissions and the Affordable Care Act: paying for coordinated quality care. JAMA. 2011;306:1794–1795. - PubMed
-
- Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418–1428. - PubMed
-
- Covinsky KE, Palmer RM, Fortinsky RH, et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc. 2003;51:451–458. - PubMed
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