Influence of Cognition on Length of Stay and Rehospitalization in Older Veterans Admitted for Post-Acute Care

Abstract

Objectives: Evaluate the relative contribution of cognitive test performance to post-acute care (PAC) length of stay (LOS) and rehospitalization while controlling for key demographic, medical, and functional outcomes. Methods: Retrospective medical record review of 160 older Veterans, including cognitive test performance (Addenbrooke’s Cognitive Examination–Revised [ACE-R]), on admission to a Veterans Administration Hospital Community Living Center (CLC) PAC. Results: Individuals with impaired scores on the ACE-R had a longer LOS (10 median days longer; U = 2,547.00, p = .028). Of those rehospitalized, 71.4% ( n = 20) screened positive for cognitive impairment. Key medical factors explained the largest amount of variance in CLC-PAC LOS (29.8%), followed by admission ADL (activities of daily living) dependency (4.6%) and ACE-R total score (3.30%). Discussion: Cognitive screening should be considered on PAC admission, with impairment on ACE-R predicting geriatric rehabilitation outcomes such as risk of increased LOS and rehospitalization.