title: Geriatric patients with cognitive impairment.
abstract: BACKGROUND
  Hospitals are now faced with increasing numbers of cognitively impaired patients aged 80 and older who are at increased risk of treatment complications. This study concerns the outcomes when such patients are treated in a specialized ward for cognitive geriatric medicine.
  
  
  METHODS
  Observation of a cohort of 2084 patients from 2009 to 2014, supplemented by a sample of 380 patients from the hospital cohort of the Longitudinal Urban Cohort Ageing Study (LUCAS) for the years 2010 and 2011.
  
  
  RESULTS
  Geriatric inpatients with cognitive impairment tend to be multimorbid. Half of the patients studied (1031 of 2084 patients) were admitted to the hospital on an emergency basis. Complications arising on the ward that necessitated transfer elsewhere arose in 2.6% (51 of 2084 patients). Moreover, analysis of the sample of 380 patients from the LUCAS cohort revealed that the treatments they underwent during hospitalization were associated with an improvement of their functional state: their mean overall score on the Barthel index rose from 39.8 ± 24.3 (median, 35) on admission to 52.7 ± 27.0 (median, 55) on discharge. The percentage of patients being treated with 5 or more drugs fell from 98.2% (373/380) on admission to 79.3% (314/362) on discharge. The percentage receiving potentially inappropriate medications (PIM), as defined by the PRISCUS list, fell from 45% to 13.3%, while the percentage of drug orders and prescriptions involving PIM fell from 7.8 % (327/4181) to 2.0% (53/2600). 70% of the patients were discharged to the same living situation where they had been before admission.
  
  
  CONCLUSIONS
  In this study, structured geriatric treatment in a cohort of older acutely ill patients with cognitive impairment was associated with improvement of functions that are relevant to everyday life, as well as with a reduction of polypharmacy. Controlled studies are needed to confirm the observed benefit.
authors.affiliation: Albertinen-Haus, Geriatrics Centre, Scientific Department at the University of Hamburg, Hamburg, Germany, Albertinen-Haus, Geriatrics Centre, Scientific Department at the University of Hamburg, Research Department, Hamburg Germany, Albertinen-Hospital, Department of Medical Controlling, Hamburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: von Renteln-Kruse
authors.forename: Lilli
authors.initials: L
authors.lastname: Neumann
authors.forename: Björn
authors.initials: B
authors.lastname: Klugmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Liebetrau
authors.forename: Stefan
authors.initials: S
authors.lastname: Golgert
authors.forename: Ulrike
authors.initials: U
authors.lastname: Dapp
authors.forename: Birgit
authors.initials: B
authors.lastname: Frilling
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome