| Abstract: | Background/Aims Cognitive impairment (CI) among hospitalized patients is associated with lack of functional recovery, rehospitalization, and death but limited data exists on CI in patients hospitalized for acute coronary syndromes (ACS). We examine the prevalence of, and factors associated with, CI among patients with an ACS. Methods Adults (n = 623 to date) in central MA or Macon, GA without dementia or delirium were interviewed during hospitalization for an ACS as part of an ongoing study within the Transitions, Risk, and Actions in Coronary Events: Center for Outcomes Research and Education (TRACE-CORE). CI was indicated by a score =30 on the Telephone Interview of Cognitive Status (TICS; range = 0-41) Patients reported demographic and psychosocial factors: anxiety (GAD8; >4=high anxiety), depression (PHQ9; >4= high depressive symptoms), stress (PSS4; range 0-20), medication adherence (Morisky Scale), and health-related quality of life (SF-36). Patient characteristics were compared by CI status using chi-squared and t-tests. Results Participants were 65% (405 of 623) male, 77% (479 of 623) non-Hispanic white and 14% (87 of 623) African-American, and aged 61.3±11.0 years. Thirty percent of patients hospitalized for ACS were cognitively impaired (187 of 623). In general, patients with CI were only mildly impaired (mean TICS = 28.4). Compared to patients who were cognitively intact, patients with CI were less educated (post high school: 69% vs. 85%) and were more likely to have high levels of depressive symptoms and anxiety (p's<0.05). Impaired patients had higher mean stress levels (5.8 vs. 4.7) and significantly lower average quality of life in both the physical (38.7 vs. 42.0) and mental (43.5 vs. 47.3, all p's<0.001) health domains of the SF-36. Patients with CI were more likely to report caregiving support (19% (118 of 623) vs. 11% (68 of 623), p=0.02). Age, sex, race/ethnicity, and self-reported medication adherence did not differ by CI. Discussion CI is highly prevalent among patients hospitalized for ACS. Screening for CI would identify patients who may require tailored transitional care or closer post-discharge monitoring. Future work in this study will examine the trajectory of cognitive function after discharge, comparing factors associated with persistent versus transient CI. |
