Inpatient stay for older adults: a double-edged sword for cognition?

Lucia Chinnappa-Quinn et al.’s recent carefully conducted systematic review and meta-analysis provided preliminary evidence of higher risk of cognitive decline following hospitalization for acute physical illnesses in older adults without preexisting clinical dementia, while taking into consideration a wide range of potential risk factors involving both patient and hospitalization factors (Chinnappa-Quinn et al., 2020). Having less access to health care services has been postulated to account for the increased risk of dementia in older adults without history of general anesthesia exposure (Yip et al., 2006), and a recent finding published by Velkers et al. showed that elective surgeries involving the use of general anesthesia were not associated with higher risk of incident dementia (Velkers, 2021); these suggest that some inpatient treatments, especially those that can improve older adults’ health and well-being, might be beneficial rather than detrimental to cognition in the long run. In brief, health promotion and disease prevention through education, lifestyle modification, vaccination, optimization of risk factors for acute illnesses, strengthening cognitive resilience, and improving mental health are some examples of primary prevention activities that might attenuate the likelihood of acute illness from developing and reduce the need for hospitalization services in the first place (World Health Organization, 2017).