A new study found that patients admitted to skilled nursing facilities for short-term recovery after hospitalization were more apt to have worse cognitive and functional recovery if they developed delirium or dementia soon after admission.
Patients who need to go to a skilled nursing facility after hospitalization are often admitted with cognitive and functional impairments. Previous research showed that about 32% of them have cognitive impairment and over 50% have functional impairment when admitted. Sometimes, the impairments resolve in about a month, allowing the individual to return home. But this isn’t always the case.
Indeed, previous research has shown that people newly admitted to a skilled nursing facility with delirium were less likely to be discharged home and more likely to die or be transferred to long-term care regardless of whether or not they had Alzheimer’s disease and related dementias (ADRD). But the combined effects of delirium and dementia on cognitive and functional recovery after facility admission hadn’t been studied until the new study.
In the new study, researchers found that when older adults without dementia were hospitalized and then admitted to a skilled nursing facility for care, those who experienced delirium or were newly diagnosed with ADRD within seven days of admission had worse outcomes over a 30-day span. Those with both conditions had the worst recovery prospects, the study found.
The report was published Thursday in the Journal of the American Geriatrics Society.
Investigators used claims data from 2011 to 2013 covering over 740,000 older adults who were newly admitted to short-stay skilled nursing facilities.
The ADRD-only and delirium-only groups were each 43% less likely to have improved cognition in the 30-day span compared with those with neither condition. People with both conditions were 55% less likely to show improved cognition within 30 days than those without either condition.
The ADRD-only group was 7% less likely to improve function in activities of daily living and the delirium-only group was 8% less likely to have improved ADL function compared with controls. Those who had both conditions were 15% less likely to show improvement in ADLS than those with neither issue.
“These findings suggest a potential role for delirium in diminishing patients’ abilities to recover the critical functioning needed to prevent long-term care placement and death,” the authors wrote.
