title: Hospitalization and cognitive decline: Can the nature of the relationship be deciphered?
abstract: BACKGROUND
  Evidence for a relationship between hospitalization and incident cognitive decline exists mainly in the literature focusing on critical care hospitalization. Recent studies, however, have also found an association between noncritical care hospitalization and the development of cognitive decline.
  
  
  OBJECTIVE
  This article will review the literature pertaining to hospitalization and cognitive decline, including hospitalizations for both critical and noncritical care, and in medical and surgical patients. The article will also explore the various factors that have been implicated in the development of cognitive decline and dementia.
  
  
  METHODS
  Review of the literature was completed using PubMed and Medline search programs.
  
  
  RESULTS
  Several articles supporting evidence for the association between hospitalization and cognitive decline are available. Evidence for potential mediating factors also does exist.
  
  
  CONCLUSIONS
  There is evidence to support an association between hospitalization and development of cognitive decline. Factors that could mediate this association include, but may not be limited to, delirium, medications, stress, and depression. There is a need for further research in this area in order to better understand the underlying pathophysiology involved in the development of cognitive decline and dementia and to determine if preventive measures might be beneficial in decreasing risk for cognitive decline for patients who are hospitalized.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA; Penn Center for Women's Behavioral Wellness, University of Pennsylvania, Philadelphia, PA. Electronic address: sarah.mathews@uphs.upenn.edu.
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Mathews
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA; Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Arnold
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA; Penn Center for Women's Behavioral Wellness, University of Pennsylvania, Philadelphia, PA; Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: C Neill
authors.initials: CN
authors.lastname: Epperson
mesh_terms: D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D003422:Critical Care / Q000523:psychology; D003693:Delirium / Q000150:complications / Q000523:psychology; D003704:Dementia / Q000150:complications / Q000523:psychology; D003863:Depression / Q000150:complications / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D010361:Patients / Q000523:psychology; D055553:Prescription Drugs / Q000009:adverse effects; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology
chemical_list: D055553:Prescription Drugs
keywords: Hospitalization; cognitive decline; cognitive impairment; dementia