An Inpatient Geriatrics Program with a Focus on Any Type of Cognitive Impairment Reduces Mortality

Background No matter what type of cognitive impairment an older hospitalized patient has, the risk of mortality is increased. Objectives To describe a hospital-based geriatrics program with a focus on any type of cognitive impairment and to determine whether this program was associated with reduced mortality over time. Design, Participants and Setting Retrospective chart review of all patients age 70+ admitted during a 3-year period (2017–2019, N=20,401), to a 500-bed community-based hospital (Level 1 Trauma Center and Stroke Center). Intervention A multicomponent geriatrics program was developed and implemented throughout 2018 and included: geriatric consultation, data collection, review of the data with hospital leaders, a geriatrics task force, clinician education and a Delirium Unit. Main Outcomes and Measures Monthly mortality rates for patients with and without cognitive impairment over the 3-year period. To control for other variables associated with mortality, pre-post implementation analyses were performed (2017 versus 2019). Results A linear regression analysis showed a significant downward trend in mortality over time for patients with cognitive impairment [R 2 =0.4, P<.0001, (correlation coefficient −0.6, 95% CI, −0.8 to −0.4)] but not among patients without cognitive impairment [R 2 =0.0, P=0.829, (correlation coefficient 0.0, 95% CI, −0.3 to 0.3)]. When controlling for other variables, there was still a decrease in mortality risk among patients with cognitive impairment. Conclusion Although there are limitations to this study, a multicomponent geriatrics program with an emphasis on any type of cognitive impairment, may be associated with improved mortality.