Prevalence of cognitive impairment in Chinese older inpatients and its relationship with 1-year adverse health outcomes: a multi-center cohort study

BMC Geriatrics

Li Yuan¹  Tao Xu¹  Xiaoming Zhang²  Na Guo²  Jing Jiao²  Xinjuan Wu²  Zhen Li²  Shengxiu Zhao³  Xianxiu Wen⁴  Jingfen Jin⁵  Dongmei Lv⁶  Hui Wang⁷ 

[1] Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College;Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital;Department of Nursing, Qinghai Provincial People’s Hospital;Department of Nursing, Sichuan Provincial People’s Hospital;Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine;Department of Nursing, The Second Affiliated Hospital of Harbin Medical University;Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;

关键词: Cognitive impairment;    Older inpatients;    Adverse outcomes;    Mortality;    Frailty;    HRQoL;   

DOI  :  10.1186/s12877-021-02556-5

来源: DOAJ

【 摘 要 】

Abstract Background Previous studies on the relationship between cognitive impairment and adverse outcomes among geriatric inpatients are not representative of older inpatients in China because of insufficient sample sizes or single-center study designs. The purpose of our study was to examine the prevalence of cognitive impairment and the relationship between cognitive impairment and 1-year adverse health outcomes in older inpatients. Methods This study was a large-scale multi-center cohort study conducted from October 2018 to February 2020. Six tertiary hospitals across China were selected using a two-stage cluster sampling method, and eligible older inpatients were selected for the baseline survey and follow-up. The Mini Cognitive Scale and the FRAIL scale were used to screen for cognitive impairment and frailty, respectively. The EuroQol-5 Dimension-5 Level questionnaire was used to assess health-related quality of life (HRQoL). We used a generalized estimating model to evaluate the relationship between cognitive impairment and adverse outcomes. Results The study included 5008 men (58.02%) and 3623 women (41.98%), and 70.64% were aged 65–75 years, and 26.27% were aged 75–85 years. Cognitive impairment was observed in 1756 patients (20.35%). There were significant differences between participants with cognitive impairment and those with normal cognitive function for age, gender, surgery status, frailty, depression, handgrip strength and so on. After adjusting for multiple covariates, compared with patients with normal cognitive function, the odds ratio for 1-year mortality was 1.216 (95% confidence interval [CI]: 1.076–1.375) and for 1-year incidence of frailty was 1.195 (95% CI: 1.037–1.376) in patients with cognitive impairment. Similarly, the regression coefficient of 1-year HRQoL was − 0.013 (95% CI: − 0.024−− 0.002). In the stratified analysis, risk of adverse outcome within 1 year was higher in older patients with cognitive impairment aged over 75 years than those aged 65–74 years. Conclusions We revealed that cognitive impairment was highly correlated with occurrence of 1-year adverse health outcomes (death, frailty, and decreased HRQoL) in older inpatients, which provides a basis for formulating effective intervention measures. Trial registration Chinese Clinical Trial Registry, ChiCTR1800017682 , registered 09 August 2018.

【 授权许可】

Unknown