January 14, 2019
Compared with elective hospitalizations, non-elective hospitalizations are associated with an increased rate of cognitive decline among older adults. According to the study, published online in Neurology, emergency hospitalizations may be more of a major risk factor for long-term cognitive decline than previously thought.
“We found that those who have non-elective (emergency or urgent) hospitalizations and who have not previously been diagnosed with dementia or Alzheimer’s disease had a rapid decline in cognitive function (i.e., thinking abilities) compared to the prehospital rates,” said Bryan James, PhD, an epidemiologist and in the Rush Alzheimer’s Disease Center and an assistant professor in the Rush Department of Internal Medicine, in a statement. “By comparison, people who were never hospitalized and those who had elective hospitalizations did not experience the drastic decline in cognitive function.”
For the study, researchers from Rush University Medical Center observed 777 older adults, 81 years of age on average. The data was provided by the Rush Memory and Aging Project, a cohort study of community-dwelling older adults without baseline dementia. The researchers acquired information on hospitals by linking records of Medicare claims for the study participants from 1999 to 2010. The researchers identified the hospital admissions as elective, emergency or urgent.
According to the findings, of the participating older adults, 460 were hospitalized at least once over an average of almost five years of observation, and of those hospitalized, 222 had at least one elective hospital admission, and 418 had at least one non-elective hospital admission. Notably, these groups included 180 participants who had both types of hospitalizations.
Based on the patient hospitalizations, non-elective hospitalizations were associated with an approximately 50% acceleration in the rate of cognitive decline from before hospitalization. Further, the rate of cognitive decline was more than double the rate in older adults who were not hospitalized. Finally, elective hospitalizations were not associated with acceleration in the rate of decline.
“We saw a clear distinction: non-elective admissions drive the association between hospitalization and long-term changes in cognitive function in later life, while elective admissions do not necessarily carry the same risk of negative cognitive outcomes,” Dr James said. “These findings have important implications for the medical decision making and care of older adults.”
James BD, Wilson RS, Capuana AW, et al. Cognitive decline after elective and nonelective hospitalizations in older adults [published online January 11, 2019]. DOI: https://doi.org/10.1212/WNL.0000000000006918.
Rush University Medical Center. Emergency and Urgent Hospitalizations Linked to Accelerated Cognitive Decline in Older Adults [press release]. https://www.newswise.com/articles/view/706355/. Accessed January 14, 2019.
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