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Hospital outcomes of older people with cognitive impairment: an integrative review

Hospital outcomes of older people with cognitive impairment: an integrative review
Hospital outcomes of older people with cognitive impairment: an integrative review
Objectives

To summarise existing knowledge of outcomes of older hospital patients with cognitive impairment, including the type and frequency of outcomes reported, and the additional risk experienced by this patient group.

Methods

Integrative literature review. Health care literature databases, reports, and policy documents on key websites were systematically searched. Papers describing the outcomes of older people with cognitive impairment during hospitalisation and at discharge were analysed and summarised using integrative methods.

Results

One hundred four articles were included. A range of outcomes were identified, including those occurring during hospitalisation and at discharge. Older people with a dementia diagnosis were at higher risk from death in hospital, nursing home admission, long lengths of stay, as well as intermediate outcomes such as delirium, falls, dehydration, reduction in nutritional status, decline in physical and cognitive function, and new infections in hospital. Fewer studies examined the relationship of all‐cause cognitive impairment with outcomes. Patient and carer experiences of hospital admission were often poor. Few studies collected data relating to hospital environment, eg, ward type or staffing levels, and acuity of illness was rarely described.

Conclusions

Older people with cognitive impairment have a higher risk of a variety of negative outcomes in hospital. Prevalent intermediate outcomes suggest that changes in care processes are required to ensure maintenance of fundamental care provision and greater attention to patient safety in this vulnerable group. More research is required to understand the most appropriate ways of doing this and how changes in these care processes are best implemented to improve hospital outcomes.
0885-6230
1177-1197
Fogg, Carole
42057537-d443-462a-8944-c804252c973b
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Meredith, Paul
d0a0e287-ad7f-41cb-9347-94d7a0e957c1
Bridges, Jacqueline
57e80ebe-ee5f-4219-9bbc-43215e8363cd
Fogg, Carole
42057537-d443-462a-8944-c804252c973b
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Meredith, Paul
d0a0e287-ad7f-41cb-9347-94d7a0e957c1
Bridges, Jacqueline
57e80ebe-ee5f-4219-9bbc-43215e8363cd

Fogg, Carole, Griffiths, Peter, Meredith, Paul and Bridges, Jacqueline (2018) Hospital outcomes of older people with cognitive impairment: an integrative review. International Journal of Geriatric Psychiatry, 33 (9), 1177-1197. (doi:10.1002/gps.4919).

Record type: Article

Abstract

Objectives

To summarise existing knowledge of outcomes of older hospital patients with cognitive impairment, including the type and frequency of outcomes reported, and the additional risk experienced by this patient group.

Methods

Integrative literature review. Health care literature databases, reports, and policy documents on key websites were systematically searched. Papers describing the outcomes of older people with cognitive impairment during hospitalisation and at discharge were analysed and summarised using integrative methods.

Results

One hundred four articles were included. A range of outcomes were identified, including those occurring during hospitalisation and at discharge. Older people with a dementia diagnosis were at higher risk from death in hospital, nursing home admission, long lengths of stay, as well as intermediate outcomes such as delirium, falls, dehydration, reduction in nutritional status, decline in physical and cognitive function, and new infections in hospital. Fewer studies examined the relationship of all‐cause cognitive impairment with outcomes. Patient and carer experiences of hospital admission were often poor. Few studies collected data relating to hospital environment, eg, ward type or staffing levels, and acuity of illness was rarely described.

Conclusions

Older people with cognitive impairment have a higher risk of a variety of negative outcomes in hospital. Prevalent intermediate outcomes suggest that changes in care processes are required to ensure maintenance of fundamental care provision and greater attention to patient safety in this vulnerable group. More research is required to understand the most appropriate ways of doing this and how changes in these care processes are best implemented to improve hospital outcomes.

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Hospital outcomes of older people with cognitive impairment ACCEPTED - Accepted Manuscript
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Hospital outcomes of older people with cognitive impairment: Tables 1-4 - Accepted Manuscript
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Fogg et al 2018 International Journal of Geriatric Psychiatry - Version of Record
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More information

Accepted/In Press date: 3 April 2018
e-pub ahead of print date: 26 June 2018
Published date: September 2018

Identifiers

Local EPrints ID: 421321
URI: http://eprints.soton.ac.uk/id/eprint/421321
ISSN: 0885-6230
PURE UUID: a9a0a61e-f594-4c95-a401-a527a331d2ce
ORCID for Carole Fogg: ORCID iD orcid.org/0000-0002-3000-6185
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857
ORCID for Jacqueline Bridges: ORCID iD orcid.org/0000-0001-6776-736X

Catalogue record

Date deposited: 01 Jun 2018 16:30
Last modified: 26 Nov 2021 07:07

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Contributors

Author: Carole Fogg ORCID iD
Author: Peter Griffiths ORCID iD
Author: Paul Meredith

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