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Cognitive Decline in Elderly Post-Hospitalization

Neurology; ePub 2019 Jan 11; James, Wilson, et al

Non-elective hospitalizations are related to more dramatic acceleration in cognitive decline in older adults compared to elective hospitalizations, even after accounting for prehospital decline, a recent study found. Therefore, these findings may inform which hospital admissions pose the greatest risk to the cognitive health of older adults. Researchers evaluated data from the Rush Memory and Aging Project, a prospective cohort study of community-dwelling older persons without baseline dementia. They found:

  • Of 777 participants, 460 (59.2%) were hospitalized over a mean of 5.0 (SD=2.6) years; 222 (28.6%) had at least 1 elective and 418 (53.8%) at least 1 non-elective hospitalization.
  • Mixed-effects regression models estimated change in global cognition before and after each type of hospitalization compared to no hospitalization, adjusted for age, sex, education, medical conditions, length of stay, surgery, intensive care unit, and comorbidities.
  • Persons who were not hospitalized had a mean loss of 0.051 unit global cognition per year.
  • In comparison, there was no significant difference in rate of decline before (0.044 unit per year) or after (0.048 unit per year) elective hospitalizations.


James BD, Wilson RS, Capuano AW, et al. Cognitive decline after elective and nonelective hospitalizations in older adults. [Published online ahead of print January 11, 2019]. Neurology. doi:10.1212/WNL.0000000000006918.