Hospitalization Linked to More Cognitive Decline in Elderly (Medscape):
- “Older adults have a 2.4‑fold increase in the rate of cognitive decline after hospitalization, an increased risk that persisted after adjustment for severity of illness and length of hospital stay, according to a new study.”
- “As part of the longitudinal, population-based Chicago Health and Aging Project, researchers assessed changes in cognitive function among older people. They used a composite of cognitive tests that assessed episodic memory (immediate and delayed recall), executive function, and global cognition (Mini-Mental State Examination).”
- “…And perhaps we should be treating older people with cognitive impairment when they are hospitalized differently than we are now.”
Study: Cognitive decline after hospitalization in a community population of older persons
- Results: During a mean of 9.3 years, 1,335 of 1,870 persons (71.4%) were hospitalized at least once. In a mixed-effects model adjusted for age, sex, race, and education, the global cognitive score declined a mean of 0.031 unit per year before the first hospitalization compared with 0.075 unit per year thereafter, a more than 2.4‑fold increase. The posthospital acceleration in cognitive decline was also evident on measures of episodic memory (3.3‑fold increase) and executive function (1.7‑fold increase). The rate of cognitive decline after hospitalization was not related to the level of cognitive function at study entry (r = 0.01, p = 0.88) but was moderately correlated with rate of cognitive decline before hospitalization (r = 0.55, p = 0.021). More severe illness, longer hospital stay, and older age were each associated with faster cognitive decline after hospitalization but did not eliminate the effect of hospitalization.
- Conclusion: In old age, cognitive functioning tends to decline substantially after hospitalization even after controlling for illness severity and prehospital cognitive decline.