HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Joray, S. Articles by Büla, C. J. Search for Related Content PubMed PubMed Citation Articles by Joray, S. Articles by Büla, C. J.

Cognitive Impairment in Elderly Medical Inpatients

Detection and Associated Six-Month Outcomes

Received May 5, 2003; revised October 16, 2003, January 22, 2004; accepted January 22, 2004. From the Division of Geriatric Medicine, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (SJ,VW,CJB), and the Institute of Social and Preventive Medicine, University of Lausanne, Switzerland (VW). Send correspondence to Christophe J. Büla, M.D., CUTR Sylvana, Ch de Sylvana 10, 1066 Epalinges, Switzerland. e-mail: christophe.bula{at}chuv.hospvd.ch

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.

Key Words: Dementia • Medical Inpatients • Nursing Home Admission • Assessment

This article has been cited by other articles:

				L. V. Doering, R. Cross, M. C. Magsarili, L. Y. Howitt, and M. J. Cowan Utility of Observer-Rated and Self-Report Instruments for Detecting Major Depression in Women After Cardiac Surgery: A Pilot Study Am. J. Crit. Care., May 1, 2007; 16(3): 260 - 269. [Abstract] [Full Text] [PDF]