3702 Hypomagnesaemia and acute cognitive decline in older adults: an evaluation of clinical practice and cognitive outcomes at an NHS

Introduction Magnesium is essential for regulating cardiovascular, neuromuscular and respiratory functions. Hypomagnesemia in older adults is often overlooked and insufficiently managed. Inadequate monitoring and correction of hypomagnesemia may leave old and frail patients more vulnerable to acute cognitive decline which in some cases can be preventable. This study assessed the current management of hypomagnesaemia in older adults admitted to the geriatric wards of an NHS Trust and its association with acute cognitive decline. Methods A retrospective review of old and frail patients admitted to geriatric wards across two hospital sites over a month was conducted. Patients aged 65 years or above and those aged between 55 to 64 with clinical frailty were included. Electronic records were used to compare acute cognitive outcomes in patients with hypomagnesaemia and those with normal magnesium levels. Multivariate analysis was performed to assess predictors of acute cognitive impairment. Results Of the 667 hospitalised older adult patients included in our study, 149 (22.3%) had hypomagnesaemia, while 518 (77.7%) had normal levels. Among the 149 patients with low magnesium, 18 (12.2%) had moderate to severe deficiency (</= 0.5 mmol/L); of these, 27.8% received intravenous supplementation, 38.9% received oral supplementation and 33.3% received no treatment. The remaining 131 patients had mild hypomagnesaemia (<0.7 mmol/L), 45 (34.4%) received some form of supplementation, while 86 (65.5%) had none. Only 60 (40.3%) of all hypomagnesaemic patients had follow up magnesium levels checked. In the multivariable logistic regression model, adjusting for age, sex and potential clinical confounders, patients with hypomagnesaemia had 2.35 times greater odds of developing acute cognitive deterioration (OR (Odds ratio) = 2.354; 95% CI (Confidence interval): 1.543–3.604; p < 0.001). These findings suggest an independent association between hypomagnesaemia and cognitive decline, underscoring the need for improved recognition and management in clinical practice. Conclusion Hypomagnesaemia may be a significant contributor to acute cognitive impairment in old and frail patients.