Frailty, malnutrition, healthcare utilization, and mortality in patients with dementia and cognitive impairment obtained from hospital administrative data.

IF 3.1 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Frontiers in Medicine Pub Date : 2025-02-26 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1540050
Reshma Aziz Merchant, Ying Qiu Dong, Shikha Kumari, Diarmuid Murphy
{"title":"Frailty, malnutrition, healthcare utilization, and mortality in patients with dementia and cognitive impairment obtained from hospital administrative data.","authors":"Reshma Aziz Merchant, Ying Qiu Dong, Shikha Kumari, Diarmuid Murphy","doi":"10.3389/fmed.2025.1540050","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>With aging populations, the prevalence of dementia, frailty and malnutrition will increase. The aim of this study is twofold (a) to determine the demographic data, including frailty and malnutrition prevalence in older patients with diagnosis of dementia and/or cognitive impairment and (b) to determine its impact on outcomes such as length of stay (LOS), readmission and mortality stratified by frailty status.</p><p><strong>Methods: </strong>Retrospective single-center cohort study conducted using hospital database on older patients ≥65 yrs. admitted to a tertiary hospital between March 2022 and Dec 2023 and discharged with either primary or secondary diagnosis of dementia or cognitive impairment. Data on age, gender, ethnicity, comorbidities, discharge diagnoses, Hospital Frailty Risk Score (HFRS), Clinical Frailty Scale (CFS), activity of daily living (ADL), 3-Minute Nutrition Screening and outcomes such as LOS, readmission, mortality and cost of hospitalization were extracted. Those aged between 65 to 74 years old were categorized as \"young-old,\" and ≥75 years old as \"old-old.\"</p><p><strong>Results: </strong>Dementia or cognitive impairment diagnosis was prevalent in 8.6% (3090) older patients, and 33.7% were malnourished. 54.5% were female with a mean age of 82.0 years. Almost one fourth were dependent on ADL. Based on frailty defined by (i) HFRS-26.0% had intermediate and 18.2% high frailty (ii) CFS-41.0% were mild/moderately frail, and 32.2% severely frail. Median LOS was 8 days. 30 and 90-days readmission rates were 23.2 and 35.4%, respectively. In-hospital mortality was 7.8% and 30-day mortality 14.0%. High HFRS (aOR 1.511, 95% CI: 1.089-2.097; <i>p</i> = 0.013), severe frailty (aOR 4.325, 95% CI: 0.960-2.684; <i>p</i> < 0.001) and terminal frailty (aOR 39.762, 95% CI: 18.311-86.344; <i>p</i> < 0.001) were significantly associated with inpatient mortality. Intermediate HFRS (aOR 1.682, 95% CI: 1.380-2.050; <i>p</i> < 0.001), mild/moderate frailty (1.609, 95% CI: 1.254-2.065; <i>p</i> < 0.01), high HFRS (aOR 2.178, 95% CI: 1.756-2.702; <i>p</i> < 0.001) and severe frailty (2.333, 95% CI: 1.804-3.017; <i>p</i> < 0.01) were significantly associated with 30-days readmission. The impact of malnutrition on healthcare utilization was highest in the old-old with high HFRS and severe frailty.</p><p><strong>Conclusion: </strong>Frailty and malnutrition have significant impact on healthcare utilization, readmission rates, and mortality among older adults with dementia and/or cognitive impairment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1540050"},"PeriodicalIF":3.1000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897001/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1540050","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: With aging populations, the prevalence of dementia, frailty and malnutrition will increase. The aim of this study is twofold (a) to determine the demographic data, including frailty and malnutrition prevalence in older patients with diagnosis of dementia and/or cognitive impairment and (b) to determine its impact on outcomes such as length of stay (LOS), readmission and mortality stratified by frailty status.

Methods: Retrospective single-center cohort study conducted using hospital database on older patients ≥65 yrs. admitted to a tertiary hospital between March 2022 and Dec 2023 and discharged with either primary or secondary diagnosis of dementia or cognitive impairment. Data on age, gender, ethnicity, comorbidities, discharge diagnoses, Hospital Frailty Risk Score (HFRS), Clinical Frailty Scale (CFS), activity of daily living (ADL), 3-Minute Nutrition Screening and outcomes such as LOS, readmission, mortality and cost of hospitalization were extracted. Those aged between 65 to 74 years old were categorized as "young-old," and ≥75 years old as "old-old."

Results: Dementia or cognitive impairment diagnosis was prevalent in 8.6% (3090) older patients, and 33.7% were malnourished. 54.5% were female with a mean age of 82.0 years. Almost one fourth were dependent on ADL. Based on frailty defined by (i) HFRS-26.0% had intermediate and 18.2% high frailty (ii) CFS-41.0% were mild/moderately frail, and 32.2% severely frail. Median LOS was 8 days. 30 and 90-days readmission rates were 23.2 and 35.4%, respectively. In-hospital mortality was 7.8% and 30-day mortality 14.0%. High HFRS (aOR 1.511, 95% CI: 1.089-2.097; p = 0.013), severe frailty (aOR 4.325, 95% CI: 0.960-2.684; p < 0.001) and terminal frailty (aOR 39.762, 95% CI: 18.311-86.344; p < 0.001) were significantly associated with inpatient mortality. Intermediate HFRS (aOR 1.682, 95% CI: 1.380-2.050; p < 0.001), mild/moderate frailty (1.609, 95% CI: 1.254-2.065; p < 0.01), high HFRS (aOR 2.178, 95% CI: 1.756-2.702; p < 0.001) and severe frailty (2.333, 95% CI: 1.804-3.017; p < 0.01) were significantly associated with 30-days readmission. The impact of malnutrition on healthcare utilization was highest in the old-old with high HFRS and severe frailty.

Conclusion: Frailty and malnutrition have significant impact on healthcare utilization, readmission rates, and mortality among older adults with dementia and/or cognitive impairment.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Frontiers in Medicine
Frontiers in Medicine Medicine-General Medicine
CiteScore
5.10
自引率
5.10%
发文量
3710
审稿时长
12 weeks
期刊介绍: Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world
期刊最新文献
Corrigendum: Same duodenal neuroendocrine tumors, different endoscopic resection methods: a case report and literature review. Editorial: Precision medicine: biomarker testing for diagnosis and treatment of cardiovascular disease. Editorial: Update on glaucoma research: from basic science to clinical practice. Exploration of key genes associated with oxidative stress in polycystic ovary syndrome and experimental validation. Pedagogical strategies for supporting learning and student well-being in environmentally sustainable healthcare.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1