Associations Between Mild Cognitive Impairment and Hospitalization and Readmission
- Autores: Kathryn E. Callahan, James Lovato, Michael E. Miller, Doug Easterling, Beth Snitz, Jeff D. Williamson
- Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 63, Nº. 9, 2015, págs. 1880-1885
- Idioma: inglés
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Resumen
Objectives To determine whether older adults with mild cognitive impairment (MCI), a condition not previously explored as a risk factor, have more hospitalizations and 30-day readmissions than those with normal cognition.
Design Post hoc analysis of prospectively gathered data on incident hospitalization and readmission from the Ginkgo Evaluation of Memory Study (GEMS), a randomized, double-blind, placebo-controlled trial designed to assess the effect of Ginkgo biloba on incidence of dementia.
Setting GEMS was conducted in five academic medical centers in the United States.
Participants Community-dwelling adults aged 75 and older with normal cognition (n = 2,314) or MCI (n = 428) at baseline cognitive testing (N = 2,742).
Measurements Index hospitalization and 30-day hospital readmission, adjusted for age, sex, race, education, clinic site, trial assignment status, comorbidities, number of prescription medications, and living with an identified proxy.
Results MCI was associated with a 17% greater risk of index hospitalization than normal cognition(adjusted hazard ratio (aHR) = 1.17, 95% confidence interval (CI) = 1.02–1.34)). In participants who lived with a proxy, MCI was associated with a 39% greater risk of index hospitalization (aHR = 1.39, 95% CI = 1.17–1.66). Baseline MCI was not associated with greater odds of 30-day hospital readmission (adjusted odds ratio = 0.90, 95% CI = 0.60–1.36).
Conclusion MCI may represent a target condition for healthcare providers to coordinate support services in an effort to reduce hospitalization and subsequent disability.
