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Hospitalizations may be major risk factor for increased cognitive decline in older adults



Urgent and urgent admissions are associated with an increase in cognitive decline in the elderly, according to researchers at Rush University Medical Center. The results of their study, published on January 11, 2019, online issue of Neurology the medical journal of the American Academy of Neurology, show that hospitalization may be a more risk factor than important for a long time. term cognitive decline in older adults than those previously recognized.

"We have found that those who have non-elective (emergency or urgent) hospitalizations and who have not been previously diagnosed with dementia or Alzheimer's disease have had a rapid decline in cognitive functions (eg, thinking abilities) compared to Pre-hospital rates, "said Bryan James, PhD, an epidemiologist and in the Rush Alzheimer's Disease Center and an assistant professor in the Rush internal medicine department. "By comparison, people who have never been hospitalized and those who have had elective hospitalizations have not experienced the drastic decline in cognitive function."

In 201

7, James and colleagues presented a preliminary version of their study results to the International Alzheimer's Association London.

Study compares hospitalization data and cognitive assessments for 777 seniors

Data from a study in 777 seniors (81 years on average, 75% of them women) were enrolled in the Rush memory and aging project (MAP) in Chicago. The study included annual cognitive assessments and clinical evaluations.

Information on admissions was acquired by linking the Medicare requests records from 1999 to 2010 for these participants with their MAP data. All hospital admissions were designated as elective, emergency or urgent. The last two were combined as non-electives for analysis.

Of the 777 participants, 460 were admitted at least once on an average of almost five years of observation. Of those who were hospitalized, 222 (29% of the total study population) had at least one elective hospitalization and 418 (54%) had at least one non-elective hospitalization. These groups included 180 participants (23%) who had both types of hospitalization.

Non-elective admissions were associated with an acceleration of approximately 50% in the rate of cognitive decline before hospitalization, and at a rate of cognitive decline that was more than twice the rate in people who were not hospitalized. . The elective hospitalizations, however, were not at all associated with the acceleration of the rate of decline

"Elective admissions do not necessarily entail the same risk"

"We have seen a clear distinction: non-elective admissions guide the 39. association between hospitalization and long-term changes in cognitive function in old age, while elective admissions do not necessarily carry the same risk of negative cognitive outcomes, "James said. "These findings have important implications for medical decision-making and care for the elderly.

" While recognizing that all medical procedures involve a certain degree of risk, this study implies that scheduled hospital meetings may not be so dangerous for the cognitive health of elderly people as emergency or urgent situations. "

It is not known why emergency and emergency hospitalizations pose a greater risk of long-term cognitive decline than elective admissions, but may be due to differences in disease levels (although the authors checked for state of health), stress or hospital procedures involved The authors plan to explore these reasons in future research.

This work expands on previous research that has shown that after being admitted, the elderly are at high risk of memory and others cognitive problems, including both transient (temporary) delirium and long-term changes in cognition, including dementia, and Utilization Project in October 2010, 40% of all hospitalized patients in the United States aged 65 and over Therefore, hospitalization may be an unrecognized risk factor for cognitive decline and dementia for a large number of older adults. that deserves more attention.

The discovery of dementia in the very early stages has become a world priority, because pharmacological treatments, prevention strategies and other interventions will probably be more effective very early in the disease process, before extensive brain damage occurs.

Source:

https://www.rush.edu/news/press-releases/emergency-and- urgent-admissions-linked with acceleration-cognitive-decline-old [19659017] // [19659018]
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