Associations Between Mild Cognitive Impairment and Hospitalization and Readmission

作者：Callahan Kathryn E^*; Lovato James F; Miller Michael E; Easterling Doug; Snitz Beth; Williamson Jeff D

来源：Journal of the American Geriatrics Society, 2015, 63(9): 1880-1885.

DOI：10.1111/jgs.13593

• rehospitalization
• mild cognitive impairment
• acute hospital utilization

OBJECTIVES: To determine whether older adults with mild cognitive impairment (MCI), a condition not previously explored as a risk factor, have more hospitalizations and 30-day readmissions than those with normal cognition.
DESIGN: Post hoc analysis of prospectively gathered data on incident hospitalization and readmission from the Ginkgo Evaluation of Memory Study (GEMS), a randomized, double-blind, placebo-controlled trial designed to assess the effect of Ginkgo biloba on incidence of dementia.
SETTING: GEMS was conducted in five academic medical centers in the United States.
PARTICIPANTS: Community-dwelling adults aged 75 and older with normal cognition (n = 2,314) or MCI (n = 428) at baseline cognitive testing (N = 2,742).
MEASUREMENTS: Index hospitalization and 30-day hospital readmission, adjusted for age, sex, race, education, clinic site, trial assignment status, comorbidities, number of prescription medications, and living with an identified proxy.
RESULTS: MCI was associated with a 17% greater risk of index hospitalization than normal cognition (adjusted hazard ratio (aHR) = 1.17, 95% confidence interval (CI) = 1.02-1.34)). In participants who lived with a proxy, MCI was associated with a 39% greater risk of index hospitalization (aHR = 1.39, 95% CI = 1.17-1.66). Baseline MCI was not associated with greater odds of 30-day hospital readmission (adjusted odds ratio = 0.90, 95% CI = 0.60-1.36).
CONCLUSION: MCI may represent a target condition for healthcare providers to coordinate support services in an effort to reduce hospitalization and subsequent disability.

• 出版日期2015-9