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Hospitalizations May Hasten Cognitive Decline in the Elderly

Association more pronounced for those with more tangle pathology, neocortical Lewy bodies

FRIDAY, Nov. 1, 2019 (HealthDay News) — For older adults, a higher rate of hospitalizations is associated with more rapid cognitive decline, according to a study published online Oct. 15 in the Annals of Neurology.

Bryan D. James, Ph.D., from the Rush University Medical Center in Chicago, and colleagues studied 526 older persons without dementia at baseline who completed annual cognitive testing and were autopsied at death (mean age at death, 90.9 years) to examine whether Alzheimer disease and related neuropathologies contribute to the association between hospitalization and cognitive decline.

The researchers found that there were 1,383 hospitalizations during a mean of 5.1 years, with a mean annual rate of hospitalization of 0.5. There was no direct relation between a higher rate of hospitalization and a higher burden of any neuropathologic markers. More rapid cognitive decline was seen in association with a higher rate of hospitalization (estimate, −0.042); the association persisted after controlling for all seven neuropathologic markers (estimate, −0.040). In a model with three-way interactions of neuropathologic markers with hospitalization rate and time, a greater association was seen between hospitalization rate and faster cognitive decline in persons with more tangle pathology and persons with neocortical Lewy bodies (estimate for interaction, −0.007 and −0.117, respectively).

“This is the first study that we are aware of to provide evidence that older adults with more Alzheimer’s pathology and other dementia-related pathologies may experience worse cognitive outcomes after hospitalization,” James said in a statement.

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