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Updated: Jun 22, 2025
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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
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In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization
Ramya Kaushik1, Gail J McAvay2, Terrence E Murphy3
1Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA Network Open
|July 2, 2024
Summary
Older adults hospitalized with COVID-19 who develop delirium face higher risks of long-term functional disability and cognitive impairment after discharge. Post-hospitalization assessments are crucial for these patients.
Area of Science:
- Gerontology
- Infectious Diseases
- Neurology
Background:
- Older adults hospitalized with COVID-19 are at significant risk for delirium.
- The long-term effects of in-hospital delirium on functional and cognitive outcomes in this population remain understudied.
Purpose of the Study:
- To investigate the association between in-hospital delirium and functional disability and cognitive impairment up to 6 months post-discharge in older adults who were hospitalized for COVID-19.
Main Methods:
- A prospective cohort study included 311 adults aged 60+ hospitalized with COVID-19.
- Delirium was assessed using the Chart-based Delirium Identification Instrument (CHART-DEL).
- Functional and cognitive outcomes were evaluated at 1, 3, and 6 months post-discharge using regression models.
Main Results:
- In-hospital delirium occurred in 15.8% of the functional disability sample and 11.4% of the cognition sample.
- Delirium was significantly associated with increased functional disability (rate ratio, 1.32) and cognitive impairment (odds ratio, 2.48) over 6 months post-discharge.
Conclusions:
- In-hospital delirium is linked to worse functional and cognitive outcomes in older COVID-19 survivors.
- Routine assessment for disability and cognitive impairment is recommended for older COVID-19 patients who experienced delirium during hospitalization.
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