AAIC 2017: Accelerated cognitive decline linked to emergency hospitalizations

Written by Rosalind Hill, Future Science Group

Data presented at today’s Alzheimer’s Association International Conference (AAIC 2017, 16– 20 July) in London (UK), have revealed that older adults are at a higher risk of cognitive decline after emergency hospitalizations.
Bryan James and colleagues, of the Rush Alzheimer’s Disease Center (Rush University Medical Center, IL, USA), discovered that non-elective hospitalizations were associated with accelerated cognitive decline (compared with prehospital rates), but that elective admissions did not have an impact.

“These finding have important implications for medical decision-making and the care of older adults,” said James.

“While recognizing that all medical procedures carry some degree of risk, the study implies that planned hospital encounters may not be as dangerous to the cognitive health of older persons as emergency or urgent situations.”

Nine-hundred and thirty older adults we enrolled in the Rush Memory and Aging Project, for which annual cognitive assessments were linked to Medicare records and hospital admissions were defined as either elective, emergency or urgent (emergency and urgent were combined as ‘non-elective’ for analysis purposes).

Of the total cohort, 66% (n=613) were hospitalized at least once over an average of 4.8 years of observation, of whom 260 had at least one elective hospital admission, 553 had at least one non-elective admission, and 200 had both types of admission.

Adjusting for age, gender, education, self-reported chronic conditions, length of stay, surgeries, ICU stays and comorbidities, non-elective admissions to hospital were associated with accelerated cognitive decline, while elective admissions were not. The total rate of decline among non-elective admissions to hospital was approximately 60%.

Speaking about the study findings, James commented: “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.”

Source: AAIC 2017