Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov-Dec:85:103916.
doi: 10.1016/j.archger.2019.103916. Epub 2019 Jul 18.

The association of cognitive impairment as screened by the Mini-Cog with long term post-hospitalization outcomes

Ali Shami  1 , Maura Brennan  2 , Peter St Marie  3 , Peter K Lindenauer  4 , Mihaela S Stefan  5
Affiliations

The association of cognitive impairment as screened by the Mini-Cog with long term post-hospitalization outcomes

Ali Shami et al. Arch Gerontol Geriatr. 2019 Nov-Dec.

Abstract

Background: Prior studies have suggested that patients with cognitive impairment are at increased risk for adverse post-hospitalization outcomes. We aimed to determine if cognitive status assessed by the Mini-Cog, a quick bedside screening test, is associated with long-term outcomes.

Methods: In this secondary analysis of data from a prospective cohort study, 668 patients >65 years of age admitted to a tertiary care academic hospital over a two-year period were screened for cognitive impairment with the Mini-Cog within 24 h of admission. We performed multivariable regression adjusting for demographics, comorbidities, principal diagnoses and functional status to determine association between cognitive impairment and discharge to post-acute care, 90-day readmission and one-year mortality.

Results: Overall 35% screened positive for cognitive impairment. Those with impairment were older (median age 83 versus 78), less likely to be admitted from home and had lower functional independence and self-reported performance scores (p < 0.001 for all). Patients with cognitive impairment were more likely to be discharged to post-acute care facilities (54% versus 39%, p < 0.001). 90-day readmission rate of patients with and without cognitive impairment was 35% versus 27%; one-year survival 77% versus 84% and median length-of-stay was 4 days for both groups. Differences in readmission and mortality were not statistically significant after adjusting for covariates.

Conclusion: Cognitive impairment as screened for by the Mini-Cog was not associated with readmission, length-of-stay, or 1-year mortality but was associated with discharge to post-acute care. Other tools such as frailty assessment may be more useful in predicting these outcomes in hospitalized older adults.

Keywords: Cognition; Dementia; Mortality; Readmission.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST STATEMENT:

All authors declare no conflict of interest in the current work.

Figures

Figure 1.
Figure 1.
Kaplan-Meier survival curve of time to all cause readmission for subjects screening positive for cognitive impairment (CI) versus negative (no CI).
See this image and copyright information in PMC

References

    1. Daiello LA, Gardner R, Epstein-Lubow G, Butterfield K, Gravenstein S. Association of dementia with early rehospitalization among Medicare beneficiaries. Arch Gerontol Geriatr. 2014;59(1):162–168. - PubMed
    1. Hurd MD, Martorell P, Langa KM. Monetary costs of dementia in the United States. N Engl J Med. 2013;369(5):489–490. doi:10.1056/NEJMc1305541 - DOI - PubMed
    1. Borson S, Scanlan JM, Watanabe J, Tu SP, Lessig M. Improving identification of cognitive impairment in primary care. Int J Geriatr Psychiatry. 2006;21(4):349–355. - PubMed
    1. Raymont V, Bingley W, Buchanan A, et al. Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study. Lancet. 2004;364(9443):1421–1427. - PubMed
    1. Scanlan J, Borson S. The Mini-Cog: receiver operating characteristics with expert and naïve raters. Int J Geriatr Psychiatry. 2001;16(2):216–222. - PubMed

Publication types