Cognitive Decline One Year after Hospitalization in Older Adults without Dementia

Helvik, Anne-Sofie; Selbæk, Geir; Engedal, Knut

doi:10.1159/000343932

Cited by 14 publications

(17 citation statements)

References 64 publications

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“…A higher Charlson Comorbidity Index and a reduced functional level have induced cognitive decline; this is also the conclusion of another similar study with 1 year follow-up of patients with COPD, which at baseline hospitalization lacked cognitive impairment [61]. Cleutjens et al in a cross-sectional observational study on 90 stable COPD patients compared to 90 matched non-COPD controls, analyzed general cognitive impairment and domain-speciic cognitive impairment using a complex batery of 6 psychometric tests, after correction for comorbidities using multivariate linear and logistic regression models.…”

Section: Copd: Fundamental Pathophysiological Mechanisms Susceptible supporting

confidence: 53%

Neurocognitive Impairment as Systemic Effects of COPD

Oancea¹,

Tudorache²,

Tudorache³

2018

COPD - An Update in Pathogenesis and Clinical Management

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Mild cognitive impairment (MCI), also known as incipient dementia, is characterized by the decline of cognitive function greater than expected for a certain age and educational level of the individual but not severe enough to interfere with their daily activities. However, this mild cognitive impairment afects several areas: visuospatial, memory, atention and luency and it is a signiicant concern because it decreases the quality of life and treatment adherence of these patients. On the other hand, evidence suggests that individuals with Chronic obstructive pulmonary disease (COPD) also present an important risk of falls: 46% of these patients experience a fall/year, sometimes with fatal consequences. Standard clinical balance measures can predict the risk of falls in this population. Moreover, increased inlammatory biomarkers are associated with the decrease of cognitive functions and a higher risk of falls in this population. Patients with COPD have a higher balance and cognitive impairment than their healthy peers Therefore, it is important to identify, assess and understand the relevance of these comorbidities in order to characterize the full clinical spectrum of COPD and adjust prevention strategies, given the devastating consequences of these problems.

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Section: Copd: Fundamental Pathophysiological Mechanisms Susceptible supporting

confidence: 53%

Neurocognitive Impairment as Systemic Effects of COPD

Oancea¹,

Tudorache²,

Tudorache³

2018

COPD - An Update in Pathogenesis and Clinical Management

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“…25 In a study evaluating cognitive function 1 y after hospitalization in subjects Ն65 y old without cognitive impairment at baseline, cognitive decline (an MMSE score) was associated with higher comorbidity (Charlson comorbidity index) and reduced functional level. 26 In contrast, in a study examining the predictors of cognitive decline in subjects with hypoxemic COPD on continuous oxygen therapy over the course of a 2-y period, loss Data are mean Ϯ SD. * Education level was classified as follows: no education ϭ 1; primary school ϭ 2; high school ϭ 3; university ϭ 4.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Cognitive Function in Subjects With COPD

Dağ¹,

Bulcun

Türkel³

et al. 2016

Respir Care

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BACKGROUND: The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. METHODS: A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. RESULTS: The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. CONCLUSIONS: MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit.

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“…Length of hospital stay, age, and comorbidity severity have been reported to be associated with rate of cognitive decline after hospitalization. 3,[6][7][8] The current study has added to the literature on predictors of cognitive response to hospitalization in older adults and has identified predictors of cognitive response to hospitalization, namely nighttime sleep disturbance and daytime sleep, that are good candidates for interventional work. Cognitive-behavioral treatment for insomnia (CBTi) is an evidence-based treatment in older adults.…”

Section: Discussionmentioning

confidence: 99%

“…Older adults experience normal declines in cognitive functioning with advanced age, but they are at greater risk for decline in cognitive functioning at important points in the health continuum, such as after hospitalization. There is evidence that older adults experience cognitive decline after any hospitalization, including those involving a surgical procedure . For example, hospitalization was associated with a 2.4 times greater rate of cognitive decline than change in global cognitive functioning before admission in a longitudinal study of nearly 2,000 older adults …”

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confidence: 99%

“…Identifying predictors of cognitive decline in hospitalized older adults has the potential to affect selection of individuals best suited for elective procedures requiring hospitalization and use of preemptive interventions to lessen the negative effect of hospitalization on late‐life cognitive functioning, but little is known about potential predictors of cognitive decline in response to late‐life hospitalization . Length of hospital stay, age, and comorbidity severity have been reported to be associated with rate of cognitive decline after hospitalization, but these factors are not all readily modifiable. The identification of potentially modifiable risk factors is needed to identify those at risk of cognitive decline and to guide the development of interventions.…”

mentioning

confidence: 99%

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Decrease in Daytime Sleeping Is Associated with Improvement in Cognition After Hospital Discharge in Older Adults

Dzierzewski

Fung

Jouldjian

et al. 2014

J American Geriatrics Society

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Background/Objectives: The longitudinal association between sleep and cognitive functioning is not well understood in late-life. Examination of the association between a potentially modifiable risk factor such as sleep, and cognitive change in at-risk older adults is of both theoretical and practical importance. We examined the relationship between changes in objectively-assessed sleep and global cognitive functioning from inpatient post-acute rehabilitation to 6-months follow-up. Design: Secondary analysis of two prospective, longitudinal studies. Setting: Inpatient rehabilitation units at a VA Medical Center. Participants: 192 older patients (mean age=73.8±9.4 years) undergoing inpatient rehabilitation. Measurements: All participants completed 7 nights/days of ambulatory sleep monitoring via wrist actigraphy (yielding an estimate of nighttime wakefulness and daytime sleep) and the Mini-Mental State Examination (MMSE; global cognitive functioning) during a post-acute inpatient rehabilitation stay and 6-months following discharge. The 5-item Geriatric Depression Scale (GDS5), Geriatric Pain Measure (GPM), and Cumulative Illness Rating Scale for Geriatrics were completed during inpatient rehabilitation. Results: Growth curve modeling (controlling for baseline age, education, gender, BMI, depression, pain, and comorbidity burden) revealed that individuals whose amount of daytime sleep decreased from inpatient post-acute rehabilitation to 6-month follow-up also experienced improvements in MMSE (β = −0.01, t(80) = β3.22, p<0.01). Change in nighttime wakefulness was not a significant predictor of change in MMSE. Conclusion: Older adults whose daytime sleeping decreased following hospital discharge also experienced improvements in cognitive functioning at 6-months follow-up. As such, daytime sleep may represent a promising candidate for targeted interventions aimed at promoting cognitive recovery following hospital discharge.

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Cognitive Decline One Year after Hospitalization in Older Adults without Dementia

Cited by 14 publications

References 64 publications

Neurocognitive Impairment as Systemic Effects of COPD

Neurocognitive Impairment as Systemic Effects of COPD

Factors Influencing Cognitive Function in Subjects With COPD

Decrease in Daytime Sleeping Is Associated with Improvement in Cognition After Hospital Discharge in Older Adults

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