March 21, 2012 -- Older people who are hospitalized may experience a worsening of their memory problems and thinking abilities after they are discharged, a new study suggests.
Exactly why this occurs is not fully understood. “Hospitalization is very common in older age and many older Americans are struggling with their [mental] function,” says researcher Robert S. Wilson, PhD. He is the senior neuropsychologist of the Rush Alzheimer's Disease Center in Chicago. “We think that people who have [mental] problems may be more likely to be hospitalized in the first place.”
The study included 1,870 people older than 65. Participants were interviewed every three years for up to 12 years to test their memory and thinking skills. Of those, 71% were hospitalized at least once during the study period.
Scores on the tests declined slightly with age. That said, scores declined twice as fast after a first hospital stay, the study shows. The results held even after researchers took into account severe illness, longer hospital stay, and older age.
In the study, just 3% of people were in the critical care unit. Most were hospitalized for general medical conditions. The findings appear in Neurology.
Good Preventive Care May Keep People Out of the Hospital
Good primary care and leading a healthy lifestyle may help prevent certain unnecessary hospitalizations. Still, “many times hospitalization is necessary,” Wilson says.
Marc L. Gordon, MD, agrees. He is the chief of neurology at Zucker Hillside Hospital in Glen Oaks, N.Y. “Try to take as good preventive care as possible so you don’t become ill and need to be hospitalized,” he says.
While this often may be easier said than done, there are some simple ways to help keep out of the hospital, he says. For example, “people who are immunized against the flu may have a lower risk of being hospitalized for complications,” he says.
Richard S. Isaacson, MD, says the new findings mirror what he sees with his own patients. He is an associate professor of clinical neurology at University of Miami Miller School of Medicine. “More likely than not, any patient with [current mental] impairment who comes out of the hospital will not return to their previous level of functioning,” he says.
“The million-dollar question is: Why is this happening? And the bigger issue is: How can we prevent it?”
Until more is known about the scope and cause of this problem, Isaacson says that people in the hospital should try to maintain a regular sleep, wake, and medication schedule.
Visitors can also help. “A supportive environment of visiting family members and friends can provide social interaction and may make a difference,” he says.
Clinton Wright, MD, is the scientific director of the Evelyn F. McKnight Brain Institute at the University of Miami. He says the new study provides a much-needed wake-up call.
Hospitalization may unmask something that is going on under the surface. “There may be some kind of process going on that they are not aware of, but it is happening and something brings it out. That something may be an illness,” he says.
The addition of new medications may also play a role in causing these declines, he says. Many older people do have risks for [mental] decline, including high blood pressure and diabetes, and better control of these factors may stave off memory and thinking decline and hospitalization, Wright says.