Hospitalization linked to subsequent incident dementia

January 01, 0001

Hospitalization linked to subsequent incident dementia

There has been data suggesting that survivors of critical care hospital stays suffer from long term cognitive decline. These US researchers sought to test whether decline in cognitive function was greater in geriatric patients undergoing acute care or critical illness hospitalizations compared with those not hospitalized via a prospective cohort study. They looked at data from 1994 through 2007 comprising 2929 community dwelling patients 65 years old and older without dementia at baseline. Individuals were screened with the Cognitive Abilities Screening Instrument (CASI) (score range, 0-100) every 2 years, and those with a score less than 86 had a clinical examination to assess for dementia.

The researchers report: "During a mean (SD) follow-up of 6.1 (3.2) years, 1601 participants had no hospitalization, 1287 had 1 or more noncritical illness hospitalizations, and 41 had 1 or more critical illness hospitalizations. The CASI score was assessed more than 45 days after discharge for 94.3% of participants. Adjusted CASI scores averaged 1.01 points lower for visits following acute care illness hospitalization compared with follow-up visits not following any hospitalization and 2.14 points lower on average for visits following critical illness hospitalization. There were 146 cases of dementia among those not hospitalized, 228 cases of dementia among those with 1 or more noncritical illness hospitalizations, and 5 cases of dementia among those with 1 or more critical illness hospitalizations. The adjusted hazard ratio for incident dementia was 1.4 following a noncritical illness hospitalization and 2.3 following a critical illness hospitalization."

The researchers concluded: "Among a cohort of older adults without dementia at baseline, those who experienced acute care hospitalization and critical illness hospitalization had a greater likelihood of cognitive decline compared with those who had no hospitalization. Noncritical illness hospitalization was significantly associated with the development of dementia."

This study finds a link between hospitalizations and subsequent dementia, although a larger data set is needed to clarify the relationship in critical care admissions.

For the full abstract, click here.

JAMA 303 (8): 763-770, 24 February 2010 © 2010 to the American Medical Association
Association Between Acute Care and Critical Illness Hospitalization and Cognitive Function in Older Adults. William J. Ehlenbach, Catherine L. Hough, Paul K. Crane, et al.

Category: N. Neurological. Keywords: dementia, acute care, critical care, hospitalization, cognitive decline, prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 16 March 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.