Dementia and cognitive impairment in acute care: detection, healthcare pathways and patient outcomes

WessexNeurological
Start Date: 1 Feb 2016 End Date: 30 Nov 2018

Dementia and cognitive impairment in acute care: detection, healthcare pathways and patient outcomes

The problem

Many emergency admissions are older people with dementia or cognitive impairment. People aged 75 and above are screened for dementia, to provide better care in hospital. We don’t know how people who are screened and have cognitive impairment (CI) but no previously diagnosed dementia fare in hospital i.e. if they have poorer outcomes and if so why this should be the case?

The solution

Our aim is to research:
• How able, physically and mentally people with CI are at admission and their subsequent outcomes.
• An exploration of key factors which may contribute to their outcomes, e.g. nutritional status during admission, patterns of deterioration according to acuity scores (National Early Warning Score) and identification of ‘at risk’ groups.

Impact so far

• In this study, 11.6% of unscheduled admissions aged ≥75 had cognitive impairment, but no dementia diagnosis. 
• These patients had a comparable risk of dying in hospital to patients with dementia, and longer lengths of stay.
• Person-centred care such as that used for people with dementia may also be appropriate for these patients.

Further research is required to explore contributory factors to the poor outcomes in this patient group.

Contact 
Carole Fogg
carole.fogg@port.ac.uk