Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study
Background. We tested the hypothesis that cognitive impairment upon admission (CIA) and cognitive decline (CD) during hospitalization are associated with an increased risk for functional decline (FD) in older inpatients. Methods. The Italian Group of Pharmacoepidemiology in the Elderly (Gruppo Itali...
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| Veröffentlicht in: | The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2005-12, Vol.60 (12), p.1576-1580 |
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| container_title | The journals of gerontology. Series A, Biological sciences and medical sciences |
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| creator | Pedone, Claudio Ercolani, Sara Catani, Marco Maggio, Dario Ruggiero, Carmelinda Quartesan, Roberto Senin, Umberto Mecocci, Patrizia Cherubini, Antonio |
| description | Background. We tested the hypothesis that cognitive impairment upon admission (CIA) and cognitive decline (CD) during hospitalization are associated with an increased risk for functional decline (FD) in older inpatients. Methods. The Italian Group of Pharmacoepidemiology in the Elderly (Gruppo Italiano di Farmacoepidemiologia nell'Anziano, GIFA) project was a multicenter survey of 9061 older patients admitted to Italian hospitals between 1991 and 1997. CIA was defined as a Hodkinson Abbreviated Mental Test score |
| doi_str_mv | 10.1093/gerona/60.12.1576 |
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We tested the hypothesis that cognitive impairment upon admission (CIA) and cognitive decline (CD) during hospitalization are associated with an increased risk for functional decline (FD) in older inpatients. Methods. The Italian Group of Pharmacoepidemiology in the Elderly (Gruppo Italiano di Farmacoepidemiologia nell'Anziano, GIFA) project was a multicenter survey of 9061 older patients admitted to Italian hospitals between 1991 and 1997. CIA was defined as a Hodkinson Abbreviated Mental Test score <7 on admission. The percentage of participants who developed FD, defined as loss of the ability to perform without help one or more activities of daily living between admission and discharge, was compared in patients who did and did not have CIA, and between those who lost at least one point in Hodkinson Abbreviated Mental Test score (CD) and those who did not. Results. Mean age was 77.4 years, and women represented 52.3% of the sample. CIA was present in 21.0% of the patients. During hospitalization, 176 patients (1.9%) experienced FD (4% of those with CIA vs 1.3% of those without CIA). In multivariate analysis, CIA was an important risk factor for FD (odds ratio 2.4; 95% confidence interval, 1.7–3.5; p <.001), independent of age, gender, comorbidity, polypharmacy, and disability on admission. CD occurred in 3.7% of the sample and was strongly associated with an increased risk for FD (odds ratio 16.0; 95% confidence interval, 10.8–23.6; p <.001). Conclusions. Elderly patients with CIA have a higher risk for FD. New strategies should be implemented to prevent FD in patients with cognitive impairment, who account for a high percentage of older persons who are admitted to hospitals.</description><identifier>ISSN: 1079-5006</identifier><identifier>EISSN: 1758-535X</identifier><identifier>DOI: 10.1093/gerona/60.12.1576</identifier><identifier>PMID: 16424291</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Activities of Daily Living ; Aged ; Cognition & reasoning ; Cognition Disorders - physiopathology ; Disease Progression ; Female ; Hospitalization ; Humans ; Hypothesis testing ; Male ; Older people ; Patient Admission ; Risk Factors ; Severity of Illness Index</subject><ispartof>The journals of gerontology. Series A, Biological sciences and medical sciences, 2005-12, Vol.60 (12), p.1576-1580</ispartof><rights>Copyright Gerontological Society of America, Incorporated Dec 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-459de2c05f7f20543f4e1e84181f8b17658779f5de28b6847c744b0b28d455413</citedby><cites>FETCH-LOGICAL-c407t-459de2c05f7f20543f4e1e84181f8b17658779f5de28b6847c744b0b28d455413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16424291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pedone, Claudio</creatorcontrib><creatorcontrib>Ercolani, Sara</creatorcontrib><creatorcontrib>Catani, Marco</creatorcontrib><creatorcontrib>Maggio, Dario</creatorcontrib><creatorcontrib>Ruggiero, Carmelinda</creatorcontrib><creatorcontrib>Quartesan, Roberto</creatorcontrib><creatorcontrib>Senin, Umberto</creatorcontrib><creatorcontrib>Mecocci, Patrizia</creatorcontrib><creatorcontrib>Cherubini, Antonio</creatorcontrib><creatorcontrib>GIFA Study Group</creatorcontrib><creatorcontrib>on Behalf of the GIFA Study Group</creatorcontrib><title>Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study</title><title>The journals of gerontology. Series A, Biological sciences and medical sciences</title><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><description>Background. We tested the hypothesis that cognitive impairment upon admission (CIA) and cognitive decline (CD) during hospitalization are associated with an increased risk for functional decline (FD) in older inpatients. Methods. The Italian Group of Pharmacoepidemiology in the Elderly (Gruppo Italiano di Farmacoepidemiologia nell'Anziano, GIFA) project was a multicenter survey of 9061 older patients admitted to Italian hospitals between 1991 and 1997. CIA was defined as a Hodkinson Abbreviated Mental Test score <7 on admission. The percentage of participants who developed FD, defined as loss of the ability to perform without help one or more activities of daily living between admission and discharge, was compared in patients who did and did not have CIA, and between those who lost at least one point in Hodkinson Abbreviated Mental Test score (CD) and those who did not. Results. Mean age was 77.4 years, and women represented 52.3% of the sample. CIA was present in 21.0% of the patients. During hospitalization, 176 patients (1.9%) experienced FD (4% of those with CIA vs 1.3% of those without CIA). In multivariate analysis, CIA was an important risk factor for FD (odds ratio 2.4; 95% confidence interval, 1.7–3.5; p <.001), independent of age, gender, comorbidity, polypharmacy, and disability on admission. CD occurred in 3.7% of the sample and was strongly associated with an increased risk for FD (odds ratio 16.0; 95% confidence interval, 10.8–23.6; p <.001). Conclusions. Elderly patients with CIA have a higher risk for FD. New strategies should be implemented to prevent FD in patients with cognitive impairment, who account for a high percentage of older persons who are admitted to hospitals.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Cognition & reasoning</subject><subject>Cognition Disorders - physiopathology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Hypothesis testing</subject><subject>Male</subject><subject>Older people</subject><subject>Patient Admission</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><issn>1079-5006</issn><issn>1758-535X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1vEzEQhi1ERdvAD-CCLA69betve7lVabcbNRIIAlRcLO-uN3G7H6ntRYRfj6NEIDGXmVfzzGhGLwBvMbrEKKdXa-vHwVyJJMkl5lK8AGdYcpVxyh9ephrJPOMIiVNwHsIj2gcnr8ApFowwkuMzsLvtGuu7HfxkorNDDPC7ixs4H9eDi-6nhYt-a5zvUwuWJmkDS7fewM8uPMF29LCYhjq6dEYHb2zducHCm8m7YQ3LMWxdNJ37bfbAB7jaWHi3KK7hlzg1u9fgpDVdsG-OeQa-FrereZktP94t5tfLrGZIxozxvLGkRryVLUGc0ZZZbBXDCreqwlJwJWXe8gSpSigma8lYhSqiGsY5w3QGLg57t358nmyIunehtl1nBjtOQYscSUkVTeD7_8DHcfLpsaAJUoIQmbgZwAeo9mMI3rZ6611v_E5jpPem6IMpWiRJ9N6UNPPuuHiqetv8mzi6kIDsALgQ7a-_feOftJBUcl0-_NDLb3J1XxRUc_oHZsCXfw</recordid><startdate>20051201</startdate><enddate>20051201</enddate><creator>Pedone, Claudio</creator><creator>Ercolani, Sara</creator><creator>Catani, Marco</creator><creator>Maggio, Dario</creator><creator>Ruggiero, Carmelinda</creator><creator>Quartesan, Roberto</creator><creator>Senin, Umberto</creator><creator>Mecocci, Patrizia</creator><creator>Cherubini, Antonio</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20051201</creationdate><title>Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study</title><author>Pedone, Claudio ; Ercolani, Sara ; Catani, Marco ; Maggio, Dario ; Ruggiero, Carmelinda ; Quartesan, Roberto ; Senin, Umberto ; Mecocci, Patrizia ; Cherubini, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-459de2c05f7f20543f4e1e84181f8b17658779f5de28b6847c744b0b28d455413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Cognition & reasoning</topic><topic>Cognition Disorders - physiopathology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Hypothesis testing</topic><topic>Male</topic><topic>Older people</topic><topic>Patient Admission</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pedone, Claudio</creatorcontrib><creatorcontrib>Ercolani, Sara</creatorcontrib><creatorcontrib>Catani, Marco</creatorcontrib><creatorcontrib>Maggio, Dario</creatorcontrib><creatorcontrib>Ruggiero, Carmelinda</creatorcontrib><creatorcontrib>Quartesan, Roberto</creatorcontrib><creatorcontrib>Senin, Umberto</creatorcontrib><creatorcontrib>Mecocci, Patrizia</creatorcontrib><creatorcontrib>Cherubini, Antonio</creatorcontrib><creatorcontrib>GIFA Study Group</creatorcontrib><creatorcontrib>on Behalf of the GIFA Study Group</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The journals of gerontology. Series A, Biological sciences and medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pedone, Claudio</au><au>Ercolani, Sara</au><au>Catani, Marco</au><au>Maggio, Dario</au><au>Ruggiero, Carmelinda</au><au>Quartesan, Roberto</au><au>Senin, Umberto</au><au>Mecocci, Patrizia</au><au>Cherubini, Antonio</au><aucorp>GIFA Study Group</aucorp><aucorp>on Behalf of the GIFA Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study</atitle><jtitle>The journals of gerontology. Series A, Biological sciences and medical sciences</jtitle><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><date>2005-12-01</date><risdate>2005</risdate><volume>60</volume><issue>12</issue><spage>1576</spage><epage>1580</epage><pages>1576-1580</pages><issn>1079-5006</issn><eissn>1758-535X</eissn><abstract>Background. We tested the hypothesis that cognitive impairment upon admission (CIA) and cognitive decline (CD) during hospitalization are associated with an increased risk for functional decline (FD) in older inpatients. Methods. The Italian Group of Pharmacoepidemiology in the Elderly (Gruppo Italiano di Farmacoepidemiologia nell'Anziano, GIFA) project was a multicenter survey of 9061 older patients admitted to Italian hospitals between 1991 and 1997. CIA was defined as a Hodkinson Abbreviated Mental Test score <7 on admission. The percentage of participants who developed FD, defined as loss of the ability to perform without help one or more activities of daily living between admission and discharge, was compared in patients who did and did not have CIA, and between those who lost at least one point in Hodkinson Abbreviated Mental Test score (CD) and those who did not. Results. Mean age was 77.4 years, and women represented 52.3% of the sample. CIA was present in 21.0% of the patients. During hospitalization, 176 patients (1.9%) experienced FD (4% of those with CIA vs 1.3% of those without CIA). In multivariate analysis, CIA was an important risk factor for FD (odds ratio 2.4; 95% confidence interval, 1.7–3.5; p <.001), independent of age, gender, comorbidity, polypharmacy, and disability on admission. CD occurred in 3.7% of the sample and was strongly associated with an increased risk for FD (odds ratio 16.0; 95% confidence interval, 10.8–23.6; p <.001). Conclusions. Elderly patients with CIA have a higher risk for FD. New strategies should be implemented to prevent FD in patients with cognitive impairment, who account for a high percentage of older persons who are admitted to hospitals.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>16424291</pmid><doi>10.1093/gerona/60.12.1576</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The journals of gerontology. Series A, Biological sciences and medical sciences, 2005-12, Vol.60 (12), p.1576-1580 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Activities of Daily Living Aged Cognition & reasoning Cognition Disorders - physiopathology Disease Progression Female Hospitalization Humans Hypothesis testing Male Older people Patient Admission Risk Factors Severity of Illness Index |
| title | Elderly Patients With Cognitive Impairment Have a High Risk for Functional Decline During Hospitalization: The GIFA Study |
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