![]() ![]() Data were extracted retrospectively from medical records. The study population comprised 103 older participants. Exclusion criteria were palliative situation. Inclusion criteria for the analysis were 60 years or older, and two screening results for cognitive function with the German MoCA on admission (MoCA original form) and at discharge (MoCA alternate-form). Participants were admitted to the geriatric acute care ward. This observational study was undertaken retrospectively between November 2018 to December 2019 in the acute care geriatric hospital department of Marien Hospital Herne, Ruhr University Bochum, Germany. Therefore, we analysed a set of randomly selected patients in which a MoCA-follow-up test was performed during one hospital stay, to measure the prevalence, magnitude and domains of cognitive changes during the acute care hospital stay of geriatric patients. However, the Montreal Cognitive Assessment (MoCA), which is routinely used in the our geriatric hospital department, is validated for retesting while using three different forms. Particularly cognitive screening instruments are mostly not validated for retesting. In addition, it is unclear with which magnitude these cognitive changes occur and if specific domains of cognitive function are affected more frequently.ĭue to potential learning effects, cognitive follow-up testing is problematic and sometimes not reliable. Up to now, it is not known, how many older hospitalized patients experience cognitive changes independently from delirium and subsyndromal delirium. ![]() In addition, because clinical symptoms are lacking, we assume that only in few patients these cognitive changes are detected during routine hospital care, in particular if a follow-up testing of cognitive function is not performed. Due to the lack of any related symptoms, we would not categorize this manifestation as subsyndromal delirium. However, in geriatric acute care patients with short-term follow-up measurement of cognitive function, we frequently observe significant changes in cognitive function without any other clinical symptom. Surprisingly, this entity has not been characterized for patients without an operation. įor patients with cognitive dysfunction induced by a surgical intervention, the entity of postoperative cognitive dysfunction (POCD) has been described for this situation, which is distinct from postoperative delirium. According to the literature, subsyndromal delirium seems to be as common as delirium, and comprises the same diagnostic criteria as delirium, such as acute or subacute onset, disturbed attention, fluctuating course and disorganized thinking, but without the severity of delirium. not fulfilling the diagnostic criteria of delirium or subsyndromal delirium. However, in addition to the entity of delirium we frequently observe geriatric patients with changes in cognitive function during hospital stay without further clinical symptoms, i.e. The high prevalence of postoperative delirium and delirium during acute disease in older hospitalized patients is well known. German Clinical trial register (DRKS-ID: DRKS00025157 on ). We propose the term “acute disease induced cognitive dysfunction” (ADICD) for this entity. ![]() ConclusionĬognitive changes frequently occur during acute disease of geriatric patients independently from delirium. There was no significant association between delirium during hospital stay and the prevalence and magnitude of changes in total MoCA score. 46 (44.7%) patients experienced significant changes of cognitive function 2 MoCA points without delirium. 12 (11.7%) patients suffered from delirium. The mean difference of the total MoCA score was − 0.1 (☓.5). The total MoCA score on admission was 17.8 (±4.5) and at discharge 17.7 (±4.4). In this retrospective study, cognitive function was assessed with the Montreal Cognitive Assessment on admission and discharge in 103 acute care geriatric hospital patients. It is unknown, how many older hospitalized patients experience cognitive changes independently from delirium. ![]()
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