Journal Article

Long-Term Cognitive Impairment after Hospitalization for Community-Acquired Pneumonia: a Prospective Cohort Study

Grijalva, Carlos G, Self, Wesley H, Girard, Timothy D, Zhu, Yuwei, Williams, Derek J, Jain, Seema, Jackson, James C, Edwards, Kathryn M

2018

Overview

BackgroundRecent studies suggest older patients hospitalized for community-acquired pneumonia are at risk for new-onset cognitive impairment. The characteristics of long-term cognitive impairment after pneumonia, however, have not been elucidated.ObjectiveTo characterize long-term cognitive impairment among adults of all ages hospitalized for community-acquired pneumonia.DesignProspective cohort study.ParticipantsAdults without severe preexisting cognitive impairment who were hospitalized with community-acquired pneumonia.Main MeasuresAt enrollment, we estimated baseline cognitive function with the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). At 2- and 12-month follow-up, we assessed cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and tests of executive function, diagnosing cognitive impairment when results were ≥ 1.5 standard deviations below published age-adjusted means for the general population. We also identified subtypes of mild cognitive impairment using standard definitions.Key ResultsWe assessed 58 (73%) of 80 patients who survived to 2-month follow-up and 57 (77%) of 74 who survived to 12-month follow-up. The median [range] age of survivors tested was 57 [19–97] years. Only 8 (12%) had evidence of mild cognitive impairment at baseline according to the Short IQCODE, but 21 (38%) at 2 months and 17 (30%) at 12 months had mild cognitive impairment per the RBANS. Moderate-to-severe cognitive impairment was common among adults ≥ 65 years [4/13 (31%) and 5/13 (38%) at 2 and 12 months, respectively] but also affected many of those < 65 years [10/43 (23%) and 8/43 (19%) at 2 and 12 months, respectively]. Deficits were most often noted in visuospatial function, attention, and memory.ConclusionsA year after hospitalization for community-acquired pneumonia, moderate-to-severe impairment in multiple cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment.

• Publisher: Springer Nature B.V
• Subject: Adults / Attention / Cognition / Cognitive ability / Cohort analysis / Communities / Dementia / Executive function / Geriatric psychology / Geriatrics / Hospitalization / Impairment / Internal medicine / Older people / Patients / Pneumonia / Spatial memory