Survival of malnourished cognitively impaired older hospitalized patients

Rationale: In our society, offering extra nutritional support is a standard for malnourished patients at admission to hospital. Whether malnourished cognitively impaired older hospitalized patients would also benefit from this regimen is unknown. This prospective study assesses their 3 months and one-year overall survival. Prognostic characteristics predicting survival are also studied. Methods: This cohort included malnourished cognitively impaired older (60+) hospitalized patients (group 1: dementia, 2: delirium and 3: combination dementia/ delirium), newly admitted to an acute hospital and receiving usual nutritional care. Data on survival was completed until one year after patients' admission to the hospital. Possible prognostic characteristics predicting life-expectancy data were collected. Cox regression analyses were carried out. Results: Out of 3291 older patients, 575 patients (6%) were identified as malnourished. Of which 116 (20%) were cognitively impaired. Forty-nine patients were described to have dementia, 48 delirium and 19 a combination of dementia and delirium. Mean age was 81.6 years (SD 8.3, range 60 99 years). Thirty-six of them (31%) died within three months after hospital admission and 55 patients (47%) died within one year. Survival was not significant different between the three groups (p = 0.672, log-rank=0.672). The only prognostic characteristic was disease. Patients with a malignancy (p = 0.018) or vascular disease (p = 0.003) were more likely to die within three months after discharge (80%). Conclusion: Almost half of a cohort of malnourished cognitively impaired older, hospitalized patients died within one year after hospital admission. Patients with a malignancy or vascular disease were more likely to die early after discharge. It could be debated if extra nutritional support should be offered as a standard in patients with these diagnoses.