Less Risk of Cognitive Decline After Elective Hospitalizations

MedicalResearch.com Interview with:
Bryan D. James, PhD

Assistant Professor
Rush Alzheimer’s Disease Center
Chicago, IL 60612 

MedicalResearch.com: What is the background for this study?

Response: It has long been reported by patients, their family members, and physicians that many older adults experience long-term declines in their memory and thinking abilities after hospitalization. Studies have recently begun to confirm these reports by following older patients for years after hospitalization and repeatedly testing their cognitive abilities. A number of questions have yet to be answered, including which types of hospitalizations are most strongly related to cognitive decline.

In this study, we sought to answer whether going to the hospital for elective procedures was as risky to the cognitive health of older adults as urgent or emergency (that is, non-elective) hospitalizations.

MedicalResearch.com: What are the main findings?

Response: We found that on average, older adults did not experience accelerations in their rate of cognitive decline in the years after elective hospitalizations compared to how they were doing before the hospital stay, and overall their rate of decline looked very similar to persons who were not hospitalized. In contrast, older adults experienced dramatic accelerations in their rate of cognitive decline after emergency and urgent hospitalizations compared to their rate before the hospital (about a 50% increase). The average rate of decline after such hospitalizations was about double the rate in persons who were not hospitalized.

MedicalResearch.com: What should readers take away from your report?

Response: While all medical procedures carry some degree of risk, this study provides some initial evidence that planned hospital encounters may not be as dangerous to the cognitive health of older persons as hospitalizations under emergency or urgent situations. This may alleviate some concerns for older patients and their family members when their doctor recommend an elective procedure and medically clear them for it. Of course, more research needs to be done to confirm these findings, and to figure out why non-elective hospitalizations are related to cognitive problems and how to prevent it.

MedicalResearch.com: What recommendations do you have for future research as a result of this work 

Response: As it appears that emergency and urgent hospitalizations are the riskiest to the cognitive health of older adults, future research needs to explore what aspect of these scenarios are directly leading to cognitive problems. Is it the severity of the underlying illness that led to the hospitalization, or are their certain procedures in emergency urgent situations that affect cognition? Is it the elevated stress level or unplanned nature of these hospitalizations? There are a number of avenues to explore to unpack this unfortunate consequence of non-elective hospitalizations. 

Citation:

Neurology. 2019 Jan 11. pii: 10.1212/WNL.0000000000006918. doi: 10.1212/WNL.0000000000006918. [Epub ahead of print]

Cognitive decline after elective and nonelective hospitalizations in older adults.

James BD, Wilson RS, Capuano AW,  Boyle PA, Shah RC, Lamar M, Ely EW, Bennett DA, Schneider JA 

Jan 23, 2019 @ 7:13 pm

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