Key result
In older adults managing their own medications, cognitive dysfunction increased the odds of 30-day readmission by 13% per point decrease in Short Blessed Test score (P=0.003).
Why the study?
Does cognitive dysfunction increase the risk of 30-day hospital readmission in older adults independently managing their medications?
Observational (n=452)
No
Does cognitive dysfunction increase the risk of 30-day hospital readmission in older adults independently managing their medications?
Odds Ratio: 1.13
p-value: p=.003
Cognitive dysfunction, particularly executive dysfunction, is a significant risk factor for 30-day hospital readmission in older adults managing their own medications, especially those taking more than seven medications.
OBJECTIVES: To determine whether cognitive dysfunction, in particular impaired executive function, may be a risk factor for early readmission in older adults independently managing their medications. DESIGN: Prospective observational study. SETTING: Tertiary hospital. PARTICIPANTS: Individuals aged 65 years and older discharged to home from the medicine service of a tertiary hospital (N = 452). MEASUREMENTS: Participants underwent a cognitive assessment including the Short Blessed Test (SBT), the executive function component of the Montreal Cognitive Assessment, and the Trail-Making Test Part B (TMT-B). Hospital use and demographic data were obtained. A logistic regression model was used to fit the likelihood of readmission on the basis of participant characteristics, medication management, and cognitive performance. Likelihood of hospital readmission within 30 days was determined. RESULTS: For participants managing medications themselves, adjusted 30-day odds of readmission increased 13% on average with each point decrease in SBT score (P = .003) and 9% on average with each 0.01 decrease in TMT-B score (P = .02). For participants who were independent in medication management with more than seven medications, the odds of 30-day readmission increased 16% on average with each point decrease in SBT score (P = .01) and 15% on average with each 0.01 decrease in TMT-B score (P = .03). CONCLUSION: Cognitive dysfunction, particularly executive dysfunction, is a risk factor for readmission in individuals managing their own medications. This risk is greater in individuals taking more than seven medications. The interaction of cognitive function, medication management, and number of medications may enhance risk-stratification efforts to identify individuals at risk of early readmission.
No takes yet. Share an insight, caveat, or question.
Anderson et al. (2016) conducted an observational in Hospitalized older adults (n=452). Cognitive dysfunction (decreased SBT or TMT-B scores) was evaluated on 30-day hospital readmission (OR 1.13, p=.003). In older adults managing their own medications, cognitive dysfunction increased the odds of 30-day readmission by 13% per point decrease in Short Blessed Test score (P=0.003).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: