Older Persons Post Hospital Cognitive Decline

Original Editor - User Name

Top Contributors - Lucinda hampton and Khloud Shreif  

Introduction

Acute hospitalisations for older persons are common. Older persons post hospital admissions often exhibit substantial cognitive functioning decline even after controlling for severity of illness and prehospital cognitive decline.

Hospitalization of older persons causes a decline in independence of activities of daily living and this effect has been associated with impairment in cognitive functioning. As older person loss of cognitive function is a large and increasing public health problem, an understanding of the link to an event as common as hospitalization is very important.

Vulnerability

Older adults can be vulnerable for complications and loss of coping resources when hospitalized. That is they become less resilient. Resilience is the ability to bounce back, and to adapt well in the face of eg adversity, ill health or trauma. Resilience is a protective factor making an individual resilient to adverse events, leading to positive outcomes

Three factors related to older age that contribute to loss of resilience when hospitalized are:

1. Depression,
2. Decline in ability to perform basic activities of daily living (ADLs)
3. Cognitive impairment. Combined these conditions limit ability to cope, well-being, and health.

Management/Prevention

Older people, and particularly those with dementia, are at increased risk of developing delirium or cognitive impairment during their hospital stay. Delirium and cognitive impairments have grave short and long term consequences, for example increased mortality and falls.

Patients with cognitive impairment need person-centred, goal-directed care so any potential harms are identified and minimised, and their management aligns with their preferences.

Long-Term Cognitive Impairment Common After Critical Illness

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