Cognitive impairment in psychiatric patients and length of hospital stay

IntroductionOlder patients with psychiatric conditions often have other disorders that include different levels of cognitive impairment, modifying the presentation of psychiatric symptoms and requiring treatment adaptations [1].ObjectiveTo describe clinical profile of hospitalized patients > 65 years, and its relationship with the presence of cognitive impairment and the length of hospital stay.MethodsDescriptive and comparative study. Sample: 71 inpatients > 65 years (mean ± SD Age: 72.42 ± 5.96), admitted to “Hospital Universitario Central de Asturias”(Spain) from August 2014 to June 2015. Age, length of hospitalization, diagnosis, cognitive impairment and treatment data were collected (Table 1).ResultsDays of hospital stay (mean ± SD) = 15.89 ± 11.53. No variable showed significant relation except number of antipsychotics taken (r = 0.307, P = 0.009). Cognitive impairment was significantly more frequent in men than women (45.5/15.8%; χ2 = 7.46; P = 0.006). No other variable showed significant differences.ConclusionsA high percentage of psychiatric inpatients > 65 years present a cognitive impairment (29.6%) which was more frequent in males (45.5%). The length of hospital stay seems to be similar than in the rest of patients and not being affected by any of studied variables. More studies should be carried on to compare those results with similar variables in younger population and to analyze if there are differences between subgroups (65–75 vs > 75) [1].Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome

Geriatrics ◽

10.3390/geriatrics4040057 ◽

2019 ◽

Vol 4 (4) ◽

pp. 57 ◽

Cited By ~ 1

Author(s):

Hewitt ◽

Owen ◽

Carter ◽

Stechman ◽

Tay ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Confusion Assessment Method ◽

Assessment Method ◽

Ageing Population ◽

Multi Centre Study ◽

Logistic Regression Models ◽

Surgical Units

Background: With an ageing population, an increasing number of older adults are admitted for assessment to acute surgical units. Older adults have specific factors that may influence outcomes, one of which is delirium (acute cognitive impairment). Objectives: To establish the prevalence of delirium on admission in an older acute surgical population and its effect on mortality. Secondary outcomes investigated include hospital readmission and length of hospital stay. Method: This observational multi-centre study investigated consecutive patients, ≥65 years, admitted to the acute surgical units of five UK hospitals during an eight-week period. On admission the Confusion Assessment Method (CAM) score was performed to detect delirium. The effect of delirium on important clinical outcomes was investigated using tests of association and logistic regression models. Results: The cohort consisted of 411 patients with a mean age of 77.3 years (SD 8.1). The prevalence of admission delirium was 8.8% (95% CI 6.2–11.9%) and cognitive impairment was 70.3% (95% CI 65.6–74.7%). The delirious group were not more likely to die at 30 or 90 days (OR 1.1, 95% CI 0.2 to 5.1, p = 0.67; OR 1.4, 95% CI 0.4 to 4.1. p = 0.82) or to be readmitted within 30 days of discharge (OR 0.9, 95% CI 0.4 to 2.2, p = 0.89). Length of hospital stay was significantly longer in the delirious group (median 8 vs. 5 days respectively, p = 0.009). Conclusion: Admission delirium occurs in just under 10% of older people admitted to acute surgical units, resulting in significantly longer hospital stays.

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Cognitive screening in the acute hospital: Preliminary findings from a cognitive screening program in a university-affiliated, tertiary-referral hospital with 6-month interval outcomes

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.427 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S190-S190

Author(s):

C. Power ◽

H. Bates ◽

M. Healy ◽

P. Gleeson ◽

E. Greene

Keyword(s):

Cognitive Impairment ◽

Hospital Stay ◽

Patient Outcomes ◽

Length Of Hospital Stay ◽

Cognitive Status ◽

Acute Hospital ◽

Normative Values ◽

Discharge Destination ◽

Cognitive Screening ◽

The Impact

IntroductionCognitive impairment impacts on patient outcomes [1] but is under-recognised in acute hospitals [2]. Data on rates and degree of impairment among hospital inpatients remain sparse. This information is vital for strategic planning of health services as the European population ages.ObjectivesTo examine the rates and degree of cognitive impairment among patients aged 65 and older who were admitted to an acute general hospital and to assess its impact on patient outcomes.MethodsAll patients aged over 65 who were admitted over a 2-week period were invited to participate. Those who met the inclusion criteria were screened for delirium then underwent a cognitive screening battery. Normative values for age and level of education were obtained from the TILDA study [3]. Demographic and outcome data were obtained from medical records.ResultsOne hundred and forty-eight patients underwent cognitive screening. Thirty-nine over 148 (26%) met the DSM-IV criteria for dementia of whom only 16 (41%) had a previously-documented impairment. Thirty over 148 (20%) had evidence of cognitive impairment that did not meet criteria for dementia, only 3 (10%) of whom were previously documented. Seventy-three over 148 (49%) were normal. Six over 148 (4%) were not classifiable. The impact of cognitive status on length of hospital stay, number of readmissions in 6 months and discharge destination was investigated. Impact on length of stay was significant (P = 0.017) but significance was not achieved against number of readmissions or discharge destination.ConclusionsCognitive impairment is pervasive and under-recognised in the acute hospital and impacts on length of hospital stay. Longer interval analysis is necessary to investigate further implications.References 1–3 available upon request.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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