Screening hospitalized injured older adults for cognitive impairment and pre-injury functional impairment

Cognitive and functional impairments are leading predictors of poor outcomes among older adults, yet few hospitals collect these variables for injured older adults (IOAs). In this prospective descriptive study, we sought to determine the feasibility of screening IOAs for cognitive and pre-injury functional impairment; and to examine the prevalence of impairment at two acute care hospitals, using the Mini-Cog or Informant Questionnaire on Cognitive Decline in the Elderly (IQCDE), and Vulnerable Elder Survey (VES-13). Eighty patients were screened. Demographics included: mean age 78.7; female gender 83%; falls 89%. Cognitive impairment was present in 36 (44%) patients, and pre-injury functional impairment was present in 62 (78%) patients. Screening respondents included: patients: 53 (66%); adult children: 18 (23%); spouses: 5 (6%), and other 4 (5%). A combination of brief screening instruments for use with IOAs or surrogates is useful for capturing important variables for risk adjustment and care management.