Geriatric syndromes in elderly patients admitted to an inpatient cardiology ward

Abstract

BACKGROUND Older adults make up an increasing proportion of patients hospitalized with cardiovascular disease. Such patients often have multiple coexisting geriatric syndromes that may affect management and outcomes and are frequently underdiagnosed and untreated. OBJECTIVES To determine the prevalence of geriatric syndromes and incidence of selected adverse events in hospitalized elderly patients with cardiovascular disease. DESIGN A prospective cohort study. SETTING Urban academic medical center. PATIENTS One hundred patients at least 70 years old with cardiovascular disease hospitalized on a cardiology ward. MEASUREMENTS Standard geriatric screens were administered to assess mood, function, and cognitive status. Patients were followed prospectively for adverse events such as falls, urinary tract infection (UTI), and use of restraints. RESULTS The mean age of the patients was 79.2 ± 5.5 years, 61% were female, 68% were white, and mean length of stay was 7 days. Geriatric syndromes were prevalent and included functional impairment (35% dependent in ≥1 activity of daily living), cognitive impairment (19% with abnormal results on the Short Blessed Test), and polypharmacy. Thirty‐seven percent of patients were prescribed a potentially inappropriate medication on admission or discharge. Patients receiving a Foley catheter were at increased risk for UTI. CONCLUSIONS These findings suggest that geriatric syndromes are prevalent among older patients hospitalized for cardiovascular disease. Further study is needed to determine if interventions designed to increase recognition and treatment of these syndromes can improve outcomes in this patient population. Journal of Hospital Medicine 2007;2:394–400. © 2007 Society of Hospital Medicine.