Recognition of cognitive dysfunction in hospitalised older patients: a flash mob study.

Autor: Visser FCW; Department of Geriatric Medicine and Alzheimer Center Groningen, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, AA43, The Netherlands. f.c.w.visser@umcg.nl., van Eersel MEA; Department of Geriatric Medicine and Alzheimer Center Groningen, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, AA43, The Netherlands., Hempenius L; Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Verwey NA; Neurology and Geriatric Department, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Band C; Spaarne Gasthuis Hospital, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands., van der Bol JM; Reinier de Graaf Hospital, Geriatric Medicine, Delft, The Netherlands., Boudestein K; Department of Geriatric Medicine, Maasstad Hospital, Rotterdam, The Netherlands., van Dijk SC; Department of Geriatric Medicine, Franciscus Gasthuis and Vlietland, Schiedam, The Netherlands., Gobbens R; Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands., van der Hooft CS; Department of Geriatric Medicine, Tjongerschans Ziekenhuis, Heerenveen, The Netherlands., Kamper AM; Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands., Ruiter R; Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands., Sipers W; Department of Geriatric Medicine, Zuyderland Medical Center Sittard-Geleen, Heerlen-Sittard-Geleen, The Netherlands., Spoelstra BNA; Department of Geriatric Medicine, Meander Medisch Centrum, Amersfoort, The Netherlands., Stoffels J; Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Aging & Later Life, Amsterdam, The Netherlands., Stolwijk-Woudstra DJ; Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands., van Stralen KJ; Spaarne Gasthuis Hospital, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands., van Strien AM; Department of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Wijngaarden MA; Leiden University Medical Center, Internal Medicine, Section Geriatrics, Leiden, The Netherlands., Winters M; Departments of Internal Medicine and Geriatrics, Isala Hospital, Zwolle, The Netherlands., Strijkert F; Department of Geriatric Medicine and Alzheimer Center Groningen, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, AA43, The Netherlands., van Munster BC; Department of Geriatric Medicine and Alzheimer Center Groningen, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, AA43, The Netherlands.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2024 Jan 16; Vol. 24 (1), pp. 66. Date of Electronic Publication: 2024 Jan 16.
DOI: 10.1186/s12877-023-04588-5
Abstrakt: Background: It is important that healthcare professionals recognise cognitive dysfunction in hospitalised older patients in order to address associated care needs, such as enhanced involvement of relatives and extra cognitive and functional support. However, studies analysing medical records suggest that healthcare professionals have low awareness of cognitive dysfunction in hospitalised older patients. In this study, we investigated the prevalence of cognitive dysfunction in hospitalised older patients, the percentage of patients in which cognitive dysfunction was recognised by healthcare professionals, and which variables were associated with recognition.
Methods: A multicentre, nationwide, cross-sectional observational study was conducted on a single day using a flash mob study design in thirteen university and general hospitals in the Netherlands. Cognitive function was assessed in hospitalised patients aged ≥ 65 years old, who were admitted to medical and surgical wards. A Mini-Cog score of < 3 out of 5 indicated cognitive dysfunction. The attending nurses and physicians were asked whether they suspected cognitive dysfunction in their patient. Variables associated with recognition of cognitive dysfunction were assessed using multilevel and multivariable logistic regression analyses.
Results: 347 of 757 enrolled patients (46%) showed cognitive dysfunction. Cognitive dysfunction was recognised by attending nurses in 137 of 323 patients (42%) and by physicians in 156 patients (48%). In 135 patients (42%), cognitive dysfunction was not recognised by either the attending nurse or physician. Recognition of cognitive dysfunction was better at a lower Mini-Cog score, with the best recognition in patients with the lowest scores. Patients with a Mini-Cog score < 3 were best recognised in the geriatric department (69% by nurses and 72% by physicians).
Conclusion: Cognitive dysfunction is common in hospitalised older patients and is poorly recognised by healthcare professionals. This study highlights the need to improve recognition of cognitive dysfunction in hospitalised older patients, particularly in individuals with less apparent cognitive dysfunction. The high proportion of older patients with cognitive dysfunction suggests that it may be beneficial to provide care tailored to cognitive dysfunction for all hospitalised older patients.
(© 2024. The Author(s).)
Databáze: MEDLINE
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