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Cognitive Status of Medicare Beneficiaries Receiving Home Health Care After Cardiac Interventions

William J Dauch1, Mary Dooley1, Sara Knox2

  • 1Division of Cardiovascular Perfusion, Medical University of South Carolina, Charleston, SC, USA.

Journal of the American Medical Directors Association
|July 2, 2026
PubMed

Insights

Older adults undergoing cardiac catheterization show higher rates of cognitive impairment post-procedure compared to those having surgery. This highlights a need to understand cognitive function in patients receiving home health care after cardiac interventions.

Area of Science:

  • Gerontology
  • Cardiology
  • Neuroscience

Background:

  • Cardiac interventions are common procedures for older adults.
  • Postoperative cognitive function after cardiac interventions is not well understood.
  • Home health (HH) care offers a setting to evaluate cognitive status in this population.

Purpose of the Study:

  • To compare cognitive functional status in Medicare beneficiaries aged ≥65 years receiving HH care after catheter-based versus surgical cardiac interventions.
  • To identify factors associated with cognitive impairment in this cohort.

Main Methods:

  • Retrospective cohort study of 68,278 Medicare fee-for-service beneficiaries.
  • Participants received HH care following coronary revascularization, valve interventions, or combined procedures in 2019.
  • Cognitive function assessed using the HH Outcome and Assessment Information Set; logistic regression used for analysis.

Main Results:

  • Nearly 40% of catheterization patients and 22.4% of surgical patients exhibited cognitive impairment (P < .001).
  • Surgical intervention was associated with significantly lower odds of cognitive impairment (adjusted odds ratio, 0.594; 95% CI, 0.569-0.620) after covariate adjustment.
  • Cognitive impairment is prevalent, especially after catheter-based procedures.

Conclusions:

  • Cognitive impairment is common in older adults receiving HH care post-cardiac intervention, particularly after catheterization.
  • Differences observed may stem from patient characteristics, not solely intervention type.
  • Findings can inform strategies to enhance recovery and optimize post-acute care services.
Abstract

Keywords:
Medicarecardiac interventioncognitive functionhome healthpost-acute care

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