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Abstract:

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 .
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