Injury-related hospitalisation in community-dwelling older people across the cognitive spectrum: A population based study |
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| Institution: | 1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia;2. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2031, Australia;3. Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2031, Australia;4. Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW, 2031, Australia;5. Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, 2052, Australia;6. Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie University, NSW, 2109, Australia;7. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia;1. Kafkas University Medical Faculty, Department of Cardiology, Kars, Turkey;2. Kars Harakani State Hospital, Department of Cardiology, Kars, Turkey;3. Health Science University, Sultan Abdulhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey;4. Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Cardiology, Ankara, Turkey;5. Ataturk University Medical Faculty, Department of Cardiology, Erzurum, Turkey;1. Institute of Movement and Neurosciences, German Sport University, Cologne, Germany;2. VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Qld, Australia;3. Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Qld, Australia;4. Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-Universität Tübingen, 72076, Tuebingen, Germany;5. University of Queensland, School of Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health (CRExPAH), Australia;6. Sunshine Coast Mind and Neuroscience – Thompson Institute, University of the Sunshine Coast, Qld, Australia;1. Department of Psychology, University of the Basque Country, Donostia-San Sebastian, Spain;2. Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland;1. University School of Health and Sport (EUSES), University of Girona, Girona, Spain;2. Neurology Service, General Hospital of L''Hospitalet, L''Hospitalet de Llobregat, Spain;3. Department of Catalan Philology and General Linguistics, University of Barcelona, Spain;1. Department of Medical Affair & Planning, Taipei Veterans General Hospital, Taipei, Taiwan;2. Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan;3. Taiwan Association of Health Industry Management and Development, Taipei, Taiwan;4. Division of Dispensing, Pharmacy Department, Taipei Veterans General Hospital, Taipei, Taiwan;5. Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan;6. Maoming People’s Hospital, Guangdong Province, China;7. Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, China |
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| Abstract: | ObjectivesTo describe the injury profile, hospitalisation rates and health outcomes for older people with cognitive impairment and to determine whether these differ from those with normal cognition.MethodsParticipants were 867 community-dwelling 70–90 year olds enrolled in the population-based longitudinal Sydney Memory and Ageing Study (MAS). Participant’s cognitive status was classified as normal, mild cognitive impairment (MCI) and dementia at baseline, then 2, 4 and 6 years’ follow-up. MAS records were linked to hospital and death records to identify injury-related hospitalisations for the 2-year period following each assessment.ResultsThere were 335 injury-related hospitalisations for participants; 222 (25.6%) participants had at least one injury-related hospitalisation. The injury-related hospitalisation rate for participants with MCI (63.0 95%CI 51.6–74.4] per 1000 person-years) was higher than for people with normal cognition (39.3 95%CI 32.4–46.1] per 1000 person-years) but lower than people with dementia (137.1 95%CI 87.2–186.9] per 1000 person-years).Upper limb fractures (22.1%) were the most common injuries for participants with normal cognition, and non-fracture head injuries for participants with MCI and dementia (25.9% and 23.3% respectively). Participants with dementia had a higher proportion of hip fractures (20.0%, p = 0.0483) than participants with normal cognition. There was no difference in 30-day mortality between participants with normal cognition, MCI and dementia (3.9%, 1.7%, 3.3% respectively).ConclusionOlder people with objectively defined MCI are at higher risk of injury-related hospitalisation than their cognitively intact peers, but lower risk than people with dementia. Falls-risk screening and fall prevention initiatives may be indicated for older people with MCI. |
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| Keywords: | Injury Mild cognitive impairment Dementia Falls Aged |
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