Hospitalization of older people can lead to accelerated cognitive decline, according to new research published in the journal Neurology, and these findings reflect the need for and timeliness of recent announcements by the Center for Medicare & Medicaid Services (CMS) regarding initiatives aimed at reducing hospitalizations from skilled nursing facilities.
Rates of cognitive decline after hospitalization were shown to accelerate nearly two-and-a-half times quicker than before, the study shows. This is linked to hospitalizations yielding increased risk of loss of independence in daily living activities, the researchers say, which has been associated with impairment in cognitive functioning.
In fact, according to lead researcher Robert Wilson, rate of decline after hospitalization would be equivalent to being more than 10 years older [than prior to the hospital admission].
“Because late life loss of cognitive function is a substantial and growing public health problem, understanding its link to an event as common as hospitalization is extremely important,” said researcher Wilson (et al.) in the Neurology journal study, adding that further research could lead to developing strategies that could either reduce or prevent the effect of hospitalization on cognition.
In 2006, 23.5% of the people who transferred from a hospital setting to a skilled-nursing facility for post-acute care were rehospitalized within 30 days, according to research published in the New England Journal of Medicine in 2011.
“Several studies suggest that many of these hospitalizations are inappropriate, avoidable, or related to conditions that could be treated outside the hospital setting—and they cost more than $4 billion per year,” said research authors Joseph Ouslander and Robert Berensen, adding that avoidable hospitalizations are also common among long-stay residents of nursing homes.
With these findings in mind, the CMS’ announcement of a new initiative to reduce hospitalization from skilled nursing facilities seems especially timely.
The initiative aims to reduce costly and avoidable hospitalizations of nursing facility residents by funding organizations that would partner with the nursing facilities to provide enhanced on-site services and supports to residents.
Additionally, 23 new organizations recently joined the CMS’ Community-based Care Transitions Program (CCTP), where participants partner with hospitals and other health care and social service providers (such as skilled nursing facilities) to support Medicare patients who are at a high risk of rehospitalization.
An abstract of the Neurology study can be found here.
Written by Alyssa Gerace