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
. 2022 Jan 5;19(1):584.
doi: 10.3390/ijerph19010584.

Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction

Yi-Ting Chao  1   2 , Fu-Hsuan Kuo  1   2 , Yu-Shan Lee  1   2 , Yu-Hui Huang  1   3 , Shuo-Chun Weng  1   4   5 , Yin-Yi Chou  1   6 , Chu-Sheng Lin  1   7 , Shih-Yi Lin  1   5   8
Affiliations

Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction

Yi-Ting Chao et al. Int J Environ Res Public Health. .

Abstract

Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76-103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients.

Keywords: activity of daily living; cognitive impairment; dementia; geriatric assessment; length of stay; readmission.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Korsnes M.S., Winkler A.S. Global, regional, and national burden of dementia, 1990–2016: Predictions need local calibration. Neurology. 2020;94:718–719. doi: 10.1212/WNL.0000000000009301. - DOI - PubMed
    1. World Health Organization Dementia. 2021. [(accessed on 28 September 2021)]. Available online: https://www.who.int/news-room/fact-sheets/detail/dementia.
    1. Mukadam N., Sampson E.L. A systematic review of the prevalence, associations and outcomes of dementia in older general hospital inpatients. Int. Psychogeriatr. 2011;23:344–355. doi: 10.1017/S1041610210001717. - DOI - PubMed
    1. Beydoun M.A., Gamaldo A.A., Beydoun H.A., Shaked D., Zonderman A.B., Eid S.M. Trends, Predictors, and Outcomes of Healthcare Resources Used in Patients Hospitalized with Alzheimer’s Disease with at Least One Procedure: The Nationwide Inpatient Sample. J. Alzheimers Dis. 2017;57:813–824. doi: 10.3233/JAD-161225. - DOI - PMC - PubMed
    1. Singh I., Edwards C., Duric D., Rasuly A., Musa S.O., Anwar A. Dementia in an Acute Hospital Setting: Health Service Research to Profile Patient Characteristics and Predictors of Adverse Clinical Outcomes. Geriatrics. 2019;4:7. doi: 10.3390/geriatrics4010007. - DOI - PMC - PubMed

Publication types