Deterioro funcional asociado al deterioro cognitivo en el anciano hospitalizado

Introduction

The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥ 60 years.

Methods

Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level).Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI ≤ 75 at admission (n = 54) or with a missing BI value were excluded (n = 1). Multivariate logistic regression analyses were conducted to explore predictive factors with functional decline (BI ≤ 75) from admission to discharge, and 1-month later.

Results

Of the 133 patients included, 24.8% and 19.6% had a BI ≤ 75 at discharge and at 1-month, respectively. Compared with men, women had more than double risk for functional decline at discharge and 1-month (P < .05). Compared with those without delirium and without cognitive impairment, those with delirium and cognitive impairment had an increased risk for functional decline (BI ≤ 75) at discharge (OR 5.15, 95% CI; 1.94-13.67), and at 1-month (OR 6.26, 95% CI; 2.30-17.03). Similarly, those with comorbidity (≥ 2) had increased functional decline at discharge (OR 2.36, 95% CI; 1.14-4.87), and at 1-month after discharge (OR 2.71, 95% CI; 1.25-5.89).

Conclusion

Delirium during hospitalisation, together with cognitive impairment on admission, was a strong predictor of functional decline.