Being Hospitalized Can Cause Dementia

Medicine finally realizes the obvious!

Even as a medical resident in training over 30 years ago, it was obvious that elderly patients who were mentally OK before being hospitalized often developed dementia and confusion during their stay. In follow up, this did not always clear up after the hospitalization.

This should come as no shock.

Take someone who is elderly (or even not so elderly), remove them from their familiar environment, have them on no food (or perhaps hospital food, which is not that much better) for 3-7 days for testing and various treatments, wake them every 2-4 hours (to check blood pressure and temperature), stick needles in their veins and tubes in their bladder and rectums, and give them a bunch of mind-altering medications. When this causes disorientation and confusion, and often (understandably) combativeness, we put the patient in four-point restraints — tying their hands, feet and body to the bed.

And then physicians wonder why the patient disorients.

This new study finally confirms the obvious — that patients over 65 years of age are at higher risk of developing dementia during hospitalization. The implications:

1. Only hospitalize when necessary.
2. Keep familiar pictures and objects from home in the patient’s room. Also, have a familiar face be there whenever possible (even outside of visiting hours). Consider paying an adult family member (even if young) who the patient knows to do this, and take shifts. It will be much cheaper than a nursing home.
3. When tests and procedures are recommended, if they will be invasive or require fasting before the test, be sure they are CLEARLY necessary. The risk of causing dementia (not to mention the risk of torturing the patient — read the description above again) may, and I feel very often does, markedly outweigh the benefits of the test/treatment.

To learn more, see this article on Medscape (free registration required).