Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational...

To describe the point prevalence of cognitive impairment in hospitalised adults and evaluate the association with care needs and perceived risks of complications.

Multi-site cross-sectional study on a single day in May 2023.

Trained clinician auditors screened adult inpatients in acute medical, surgical, oncology, geriatric, mental health, convalescent, and rehabilitation wards for cognitive impairment using the 4AT in seven healthcare facilities and recorded need for support with basic activities of daily living, incontinence, and perceived risks of complications (falls, pressure injuries, and malnutrition). Data were summarised and compared across 4AT categories, and the strength of association between 4AT and each outcome was estimated using multivariable regression models.

Data were available for 1145 inpatients on 68 wards (mean age 68 years [SD = 18], 583 [58.9%] female, 449 [39.2%] on acute medical units). Cognitive impairment (4AT of 1 or more) was identified in 482 (42.1%) participants. Participants with 4AT 1-3 had 2.0-3.6 times the odds of need for supervision or assistance with activities of daily living, while those with 4AT 4 or more had 2.9-5.3 times the odds of need for assistance.

Cognitive impairment is very common in adult inpatients and is associated with significantly higher physical care needs.

Hospital care models must support staff to address the higher care needs in people with cognitive impairment to protect a large patient group from hospital-acquired harm.

No patient or public contribution.

This study adheres to the STROBE reporting guidelines.