The detection, diagnosis, and impact of cognitive impairment among inpatients aged 65 years and over in an Irish general hospital – a prospective observational study

Power, Clodagh; Duffy, Richard M.; Bates, H; Healy, M. J. R.; Lawlor, Brian A.; Greene, Elaine

doi:10.1017/s1041610217001326

Cited by 12 publications

(14 citation statements)

References 23 publications

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“…Furthermore, 1 study reported a 72% lower odds for PWD to have a LOS of 10 days or more compared to PwoD (95% CI: 0.1‐0.4) . With exception of 1 study conducted in Ireland, the remaining studies across Europe reported a longer LOS for PWD of up to 22 days . Within countries, the different studies were consistent in reporting a longer LOS for PWD compared to PwoD; however, the difference in the LOS varied up to 13 days …”

Section: Resultsmentioning

confidence: 93%

“…The mean overall score was 5.8. Eleven studies had a small sample size (range: 42‐395), were conducted in a single hospital (‐ward), or showed a sex distribution not representative of the PWD population . Thirty‐three studies met the criteria for comparability based on design or analysis, thereof 8 studies controlled or matched for 1 factor and 25 studies for at least 2 factors .…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies across 7 countries were conducted in Europe: 3 studies each in Italy, Germany, Ireland, and the UK, 2 studies from Austria and Finland, as well as 1 study from Spain . The difference in LOS among PWD compared to PwoD ranged from 0.4 to 22 days .…”

Section: Resultsmentioning

confidence: 99%

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Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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Objective Hospitalizations of people with dementia (PWD) are often accompanied by complications or functional loss and can lead to adverse outcomes. Unsystematic findings suggest an influence of comorbidities on the extent of differences in the length of hospital stay (LOS). This systematic review aimed to identify and evaluate all studies reporting LOS in PWD as compared to PwoD in general hospitals. Methods A systematic review of observational studies using PubMed and ISI Web of Knowledge. Inclusion criteria comprised original studies written in English or German, assessment of diagnosis of dementia, measurement of LOS, and comparison of people with and without dementia. Results Fifty‐two of 60 studies reported a longer hospitalization time for PWD compared to PwoD. The extent of the difference in LOS varied between and within countries as well as by type of primary morbidity (eg, injuries, cardiovascular diseases). The range of the LOS difference for studies without restriction to a primary morbidity was −2 to +22 days after matching or adjustment for a variable number and selection of potentially relevant covariates. For studies with injuries/fractures/medical procedures and infectious/vascular disease as the primary morbidity, the range was −2.9 to +12.4 and −11.2 to +21.8 days, respectively. Conclusions The majority of studies reported a longer hospitalization of PWD compared to PwoD. Length of hospital stay seems to be influenced by a variety of medical, social, organizational factors, including reasons for hospital admission, whose role should be explored in detail in further research.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

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Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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“…In most studies, CI or dementia increased length of hospital stay (LOS) . (Table ) Patients with DSD had longer mean LOS than those with dementia or delirium alone .…”

Section: Resultsmentioning

confidence: 99%

“…Patients with CI are frequently discharged to nursing/residential homes . Dementia predicts of institutionalisation (odds ratio 2.14 [1.24‐3.70]), although less so in ambulatory care sensitive conditions .…”

Section: Resultsmentioning

confidence: 99%

Hospital outcomes of older people with cognitive impairment: An integrative review

Fogg

Griffiths

Meredith

et al. 2018

Int J Geriat Psychiatry

168

137

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ObjectivesTo summarise existing knowledge of outcomes of older hospital patients with cognitive impairment, including the type and frequency of outcomes reported, and the additional risk experienced by this patient group.MethodsIntegrative literature review. Health care literature databases, reports, and policy documents on key websites were systematically searched. Papers describing the outcomes of older people with cognitive impairment during hospitalisation and at discharge were analysed and summarised using integrative methods.ResultsOne hundred four articles were included. A range of outcomes were identified, including those occurring during hospitalisation and at discharge. Older people with a dementia diagnosis were at higher risk from death in hospital, nursing home admission, long lengths of stay, as well as intermediate outcomes such as delirium, falls, dehydration, reduction in nutritional status, decline in physical and cognitive function, and new infections in hospital. Fewer studies examined the relationship of all‐cause cognitive impairment with outcomes. Patient and carer experiences of hospital admission were often poor. Few studies collected data relating to hospital environment, eg, ward type or staffing levels, and acuity of illness was rarely described.ConclusionsOlder people with cognitive impairment have a higher risk of a variety of negative outcomes in hospital. Prevalent intermediate outcomes suggest that changes in care processes are required to ensure maintenance of fundamental care provision and greater attention to patient safety in this vulnerable group. More research is required to understand the most appropriate ways of doing this and how changes in these care processes are best implemented to improve hospital outcomes.

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Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

et al. 2021

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Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

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The detection, diagnosis, and impact of cognitive impairment among inpatients aged 65 years and over in an Irish general hospital – a prospective observational study

Abstract: Cognitive impairment is pervasive and under-recognized in the acute hospital and impacts negatively on patient outcomes.

Cited by 12 publications

References 23 publications

Length of hospital stay and dementia: A systematic review of observational studies

Length of hospital stay and dementia: A systematic review of observational studies

Hospital outcomes of older people with cognitive impairment: An integrative review

Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

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