Cognitive Screening Recommended for OAs in Rehabilitation

According to study findings published online in Geriatrics, cognitive screening should be done for older adult patients in rehabilitation in order to improve outcomes through a more individualized rehabilitation plan.

“Cognitive function of older people is not routinely assessed in orthopedic rehabilitation, after elective and non-elective surgery,” wrote study authors.

In order to assess cognitive impairment among older adults admitted to orthopedic rehabilitation and understand how length of stay and functional outcomes were impacted, researchers conducted a retrospective audit. They observed adults older than 65 years with orthopedic diagnosis who were discharged from a hospital.

The study authors audited 116 files. The observed participants had a mean age of 82.3 years. Among these participants, the diagnostic groups included:

• fractured neck of femur, (n = 44, 37.98%);
• elective surgery (n = 42, 36.21%); and
• other orthopedic conditions (n = 30, 25.86%).

According to the findings, about 71.55% (n = 83) had cognitive impairment along with a median of mild cognitive impairment across all diagnoses. Additionally, length of stay (P < 0.01), function (P < 0.05), and discharge destination (P = 0.01) were all significantly linked with both measures of cognition (MoCA/FIM Cognitive).  

“A high percentage of older orthopedic patients in rehabilitation with both elective and non-elective diagnoses have cognitive impairment,” the authors concluded. “Cognitive screening is recommended for all older orthopedic patients in rehabilitation, to inform an individualized rehabilitation plan to improve outcomes and length of stay.” 

According to the research team, additional research is needed in order to explore and understand cognitive strategies so rehabilitation outcomes can be maximized and improved.  

—Julie Gould

Reference:

Carrillo CB, Barr C, George S. Cognitive Status and Outcomes of Older People in Orthopedic Rehabilitation? A Retrospective-Cohort Study. Geriatrics (Basel). 2020;5(1):E14. Published 2020 Mar 2. doi:10.3390/geriatrics5010014