Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study

Pedone, Claudio; Ercolani, Sara; Catani, Marco; Maggio, Dario; Ruggiero, Carmelinda; Quartesan, Roberto; Senin, Umberto; Mecocci, Patrizia; Cherubini, Antonio

doi:10.1093/gerona/60.12.1576

Cited by 132 publications

(124 citation statements)

References 36 publications

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“…The small convenience sample limits the generalizability of the findings. DG participants were recruited from hospital inpatients and therefore were likely to have experienced recent functional decline (Pedone et al, 2005) which may have influenced their STS performance. N-DG participants were more explicitly aware of being tested, and therefore potentially over performed and pushed through the armrests less.…”

Section: Variablesmentioning

confidence: 99%

Comparison of sit-to-stand strategies used by older adults and people living with dementia

Dolecka

Ownsworth

Kuys

2015

Archives of Gerontology and Geriatrics

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Section: Variablesmentioning

confidence: 99%

Comparison of sit-to-stand strategies used by older adults and people living with dementia

Dolecka

Ownsworth

Kuys

2015

Archives of Gerontology and Geriatrics

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“…One important source of these burdens is frequent hospitalizations and emergency department (ED) visits, many of which are potentially avoidable. These encounters are disruptive, costly, and particularly challenging for people with dementia, who are vulnerable to many adverse health outcomes, including delirium, 1 falls, 2 functional decline, 3 physical restraints, 4 and agitation and related behavioral symptoms. 5 These problems are aggravated by the poor communication abilities and coexisting medical conditions associated with dementia.…”

mentioning

confidence: 99%

Hospital And ED Use Among Medicare Beneficiaries With Dementia Varies By Setting And Proximity To Death

et al. 2014

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Hospitalizations and emergency department (ED) visits for people with Alzheimer's disease and related disorders are of particular concern because many of these patients are physically and mentally frail, and the care delivered in these settings is costly. Using data from the Health and Retirement Study linked with Medicare claims from the period 2000-08, we found that among community-dwelling elderly fee-for-service Medicare beneficiaries, those who had dementia were significantly more likely than those who did not to have a hospitalization (26.7 percent versus 18.7 percent) and an ED visit (34.5 percent versus 25.4 percent) in each year. Comparing nursing home residents who had dementia with those who did not, we found only small differences in hospitalizations (45.8 percent versus 41.9 percent, respectively) and ED use (55.3 percent versus 52.7 percent). As death neared, however, utilization rose sharply across settings and by whether or not beneficiaries had dementia: Nearly 80 percent of community-dwelling decedents were hospitalized, and an equal proportion had at least one ED visit during the last year of life, regardless of dementia. Our research suggests that substantial portions of hospitalizations and ED visits both before and during the last year of life were potentially avoidable. A lzheimer's disease and related disorders place substantial emotional, physical, and financial burdens on patients, their families, and society. One important source of these burdens is frequent hospitalizations and emergency department (ED) visits, many of which are potentially avoidable. These encounters are disruptive, costly, and particularly challenging for people with dementia, who are vulnerable to many adverse health outcomes, including delirium, 1 falls, 2 functional decline, 3 physical restraints, 4 and agitation and related behavioral symptoms. 5These problems are aggravated by the poor communication abilities and coexisting medical conditions associated with dementia. 6 Older people with dementia also have special difficulties in transitioning across care settings. 7 Hence, unnecessary or potentially avoidable hospitalizations and ED visits have important implications for both the quality of care and the quality of life for people with dementia, 8,9 especially at the end of life. 10Few studies have focused on hospital and ED use, especially potentially avoidable use, among older people with dementia.11-14 As a result, current understanding of hospital and ED use by people who have dementia compared to use by people who do not remains limited. Furthermore, there have been few analyses of the impact of dementia on hospital and ED use across community and institutional settings.

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“…Los ancianos hospitalizados con deterioro cognoscitivo de base presentan mayor riesgo para la DF. Lo anterior es explicado porque tienen mayores limitaciones para la movilidad, alteración comportamental con requerimiento de psicofármacos, inmovilización física, alteración del ciclo vigilia-sueño, que incrementan la probabilidad de presentar DF y síndromes geriátricos como caídas, delirium, incontinencia urinaria y fecal y úlceras por presión (41). El deterioro cognoscitivo al ingreso ha sido identificado en varios estudios como FR independiente para desarrollar DF al alta hospitalaria (8,41).…”

Section: Factores De Riesgo De La Declinación Funcionalunclassified

Revisión sistemática de literatura. Declinación funcional en ancianos hospitalizados

Ocampo

2016

Rev. Médica Risaralda

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Los ancianos requieren con frecuencia admisión hospitalaria, durante la cual se generan riesgos para desarrollar eventos adversos, que en ocasiones no se relacionan con las características del anciano ni la enfermedad aguda, sino con tratamientos médicos, el ambiente y las rutinas de cuidado hospitalario. Los ancianos con enfermedad aguda son un grupo heterogéneo y vulnerable debido a múltiples compromisos en las esferas biopsicosociales como disminución de la reserva funcional, comorbilidad, polifarmacia, alteraciones cognoscitivas, compromiso funcional y alteraciones en las esferas social y familiar. Estas características ubican al anciano en riesgo para desarrollar durante la hospitalización declinación funcional, por lo cual se debe realizar identificación oportuna de los factores de riesgo con el objetivo de prevenir y manejar esta condición mediante un equipo interdisciplinario.La implementación de modelos de atención que prevengan y mejoren el compromiso funcional deber ser una prioridad para las instituciones y personal de salud que atienden ancianos. Estos modelos incluyen revisión del manejo farmacológico, rehabilitación interdisciplinaria temprana, programas de ejercicio y diseño del egreso geriátrico planeado.

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Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study

Abstract: Elderly patients with CIA have a higher risk for FD. New strategies should be implemented to prevent FD in patients with cognitive impairment, who account for a high percentage of older persons who are admitted to hospitals.

Cited by 132 publications

References 36 publications

Comparison of sit-to-stand strategies used by older adults and people living with dementia

Comparison of sit-to-stand strategies used by older adults and people living with dementia

Hospital And ED Use Among Medicare Beneficiaries With Dementia Varies By Setting And Proximity To Death

Revisión sistemática de literatura. Declinación funcional en ancianos hospitalizados

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