Cognitive Decline Seen in Elderly After Hospitalization

Cognitive test scores decline more than two-fold following first hospitalization

WEDNESDAY, March 21 (HealthDay News) -- Older people may have an increased risk of memory problems after being discharged from the hospital, according to a study published online March 21 in Neurology.

Robert S. Wilson, Ph.D., of Rush University in Chicago, and colleagues analyzed longitudinal data on 1,870 older, community-dwelling residents. Participants were interviewed at three-year intervals for up to 12 years. The interviews included a set of brief cognitive tests from which measures of global cognition, episodic memory, and executive function were extracted. Hospitalization information was obtained from Medicare records.

The researchers found that, over the study period (mean 9.3 years), 1,335 participants (71.4 percent) were hospitalized at least once. Adjusting for age, sex, race, and education, the decrease in global cognitive score averaged 0.031 units per year before the first hospitalization, compared with 0.075 units per year thereafter, a more than 2.4-fold increase. The post-hospital acceleration in cognitive decline was also seen for 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 (P = 0.88) but was moderately correlated with the rate of cognitive decline before hospitalization (P = 0.021). More severe illness, longer hospital stay, and older age each were associated with faster cognitive decline after hospitalization; however, these factors did not eliminate the effect of hospitalization.

"In old age, cognitive functioning tends to decline substantially after hospitalization even after controlling for illness severity and pre-hospital cognitive decline," the authors write.

Two authors disclosed financial ties to the medical and pharmaceutical industries.

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