Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
Open accessAbstract
Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76–103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients.
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Increasing care needs due to other conditions was linked to exacerbation of dementia symptoms, increasing reliance on others, and subsequently placing more responsibility on carers (CMOC1).
“Increasing care needs due to other conditions was linked to exacerbation of dementia symptoms, increasing reliance on others, and subsequently placing more responsibility on carers (CMOC1) [28, 44, 46–48, 54, 59, 69–74].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [71]
The Discussion (page not provided) says some comorbid conditions may contribute to neurodegeneration and that malnutrition may increase dependence on care from others. The Introduction notes dementia’s effects on families. The paper does not establish the claimed sequence in which increasing care needs from other conditions exacerbate dementia symptoms and consequently increase carers’ responsibilities. (LLM, conf=0.82)
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Determinants of hospital readmissions in older people with dementia: a narrative review
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- Authors
- Chao, Y.-T., Kuo, F.-H., Lee, Y.-S., Huang, Y.-H., Weng, S.-C., Chou, Y.-Y., Lin, C.-S., & Lin, S.-Y.
- Affiliations
- Taichung Veterans General Hospital (TW)
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- National Yang Ming Chiao Tung University (TW)
- Corresponding author
- Lin, Shih-Yi
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2022-01-05
- Volume
- 19
- Issue
- 1
- Pages
- 584
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC8744733
- OpenAlex
- W4206550681
- Cited by
- 14
- References
- 47
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 1
- FWCI
- 2.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Taichung Veterans General Hospital (TCVGH-1108201E)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- cognitive impairment, hospitalized older adults, dementia, activities of daily living, Barthel Index, length of hospital stay, 30-day readmission, geriatric syndromes, multimorbidity, polypharmacy, delirium, frailty, walking speed, educational attainment, outcome determinants
- MeSH terms
- Activities of Daily Living, Aged, Cognition Disorders, Hospitalization, Humans, Inpatients, Cognitive Dysfunction
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