Association Between Acute Care and Critical Illness Hospitalization and Cognitive Function in Older Adults

Ehlenbach, William J.

doi:10.1001/jama.2010.167

Cited by 460 publications

(408 citation statements)

References 37 publications

Supporting

Mentioning

379

Contrasting

Unclassified

Order By: Relevance

“…Prior studies have identified that major depression in patients with diabetes is associated with increased risk of dementia, 15,39 and a growing body of research is identifying that hospitalizations for medical illnesses are independently associated with cognitive decline in older adults. [40][41][42][43] Taking into account the high prevalence and frequent comorbidity of depression, diabetes and dementia, additional studies are needed to test interventions aimed at reducing hospitalizations for ACSCs in patients with diabetes that utilize successful elements from existing strategies for depres- sion. 44 Such interventions could have the potential to prevent cognitive decline and enduring disability in this high-risk population.…”

Section: Discussionmentioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Hospitalizations for ambulatory caresensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate ambulatory care is provided, may be an important contributor to rising healthcare costs and public health burden. OBJECTIVE: To examine if probable major depression is independently associated with hospitalization for an ACSC in patients with diabetes. DESIGN: Secondary analysis of data from a prospective cohort study. PARTICIPANTS: Population-based cohort of 4,128 patients with diabetes ≥ 18 years old seen in primary care, who were enrolled between 2000 and 2002 and followed for 5 years (through 2007). MAIN MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire-9. Outcomes of interest included time to initial hospitalization for an ACSC and total number of ACSC-related hospitalizations. We used Cox proportional hazards regression models to ascertain an association between probable major depression and time to ACSC-related hospitalization, as well as Poisson regression for models examining probable major depression and number of ACSC-related hospitalizations. KEY RESULTS: Patients' mean age at study enrollment was 63.4 years (Standard Deviation: 13.4 years). Over the 5-year follow-up period, 981 patients in the study were hospitalized a total of 1,721 times for an ACSC, comprising 45.1 % of all hospitalizations. After adjusting for baseline demographic, clinical and health-risk behavioral factors, probable major depression was associated with initial ACSC-related hospitalization (Hazard Ratio: 1.41, 95 % Confidence Interval [95 % CI]: 1.15, 1.72) and number of ACSC-related hospitalizations (Relative Risk: 1.37, 95 % CI: 1.12, 1.68). CONCLUSIONS: Probable major depression in patients with diabetes is independently associated with hospitalization for an ACSC. Additional research is warranted to ascertain if effective interventions for depression in patients with diabetes could reduce the risk of hospitalizations for ACSCs and their associated adverse outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Nevertheless, older persons are often hospitalized, although hospitalization itself may cause adverse health outcomes (Creditor, 1993;Ehlenbach et al, 2010;S. M. Friedman, Mendelson, Bingham, & McCann, 2008).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA)

Hällgren

Fransson

Kåreholt

et al. 2016

Archives of Gerontology and Geriatrics

View full text Add to dashboard Cite

PostprintThis is the accepted version of a paper published in Archives of gerontology and geriatrics (Print). This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Citation for the original published paper (version of record):Hallgren, J., Fransson, E I., Kåreholt, I., Reynolds, C A., Pedersen, N L. et al. (2016) Factors associated with hospitalization risk among community living older persons: results from the Swedish Adoption/TwinStudy of Aging (SATSA). Archives of gerontology and geriatrics (Print AbstractThe aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46-103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR=1.02, p<0.001) and more support from relatives (HR=1.09, p=0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR=0.75, p=0.033) and widow/widower (HR=0.69, p<0.001)) and support from friends (HR=0.93, p=0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization. Key wordsHospitalization, prospective design, older persons, marital status, social factors, friends support Highlights• While medical factors are important when predicting hospitalization, social factors matter as well.• Marital status significantly affects hospitalization risk.• Hospitalization risk differs between community-living men and women.• Different factors are associated with hospitalization risk in different age groups.3

show abstract

“…Most cognitive outcome studies in critically ill populations have excluded patients with prior cognitive impairments or disorders associated with known cognitive impairments including cerebrovascular disease and dementia. Two large longitudinal population-based studies indicate that post-ICU cognitive impairment develops during or after the onset of critical illness [15,16]. However, patients with hypertension, vascular disease, coronary disease, atrial fibrillation [17], and diabetes have high rates of cognitive impairment [18]; these patients may be over-represented among the critically ill, and as such the type and number of comorbid disorders may be risk factors for cognitive sequelae.…”

Section: Confounding Variablesmentioning

confidence: 99%

“…A small proportion (*5-10 %) of ICU survivors are believed to have cognitive impairment prior to ICU admission, based on two large, population-based studies where cognitive function was tested at regular intervals [15,16]. Features by which risk can be stratified have not been identified.…”

Section: Confounding Variablesmentioning

confidence: 99%

“…Better care has resulted in reduced mortality with a concomitant increase in ICU survivors, many of whom are left with significant morbidities. Large numbers of ICU survivors have cognitive impairments [2]; these impairments are new [3,4], affect multiple cognitive domains, and are likely permanent. In this issue of Intensive Care Medicine, Wolters et al [5] systematically review studies that assess cognitive impairment following critical illness.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Post-intensive care cognitive impairment: questions in mind?

Skrobik

Hopkins

2013

Intensive Care Med

View full text Add to dashboard Cite

Association Between Acute Care and Critical Illness Hospitalization and Cognitive Function in Older Adults

Cited by 460 publications

References 37 publications

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA)

Post-intensive care cognitive impairment: questions in mind?

Contact Info

Product

Resources

About