Samenvatting

Background: It is important that healthcare professionals recognise cognitive dysfunction in hospitalised older patients in order to address associated care needs, such as enhanced involvement of relatives and extra cognitive
and functional support. However, studies analysing medical records suggest that healthcare professionals have low awareness of cognitive dysfunction in hospitalised older patients. In this study, we investigated the prevalence of cog‑
nitive dysfunction in hospitalised older patients, the percentage of patients in which cognitive dysfunction was recog‑nised by healthcare professionals, and which variables were associated with recognition.

Methods: A multicentre, nationwide, cross-sectional observational study was conducted on a single day using a fash mob study design in thirteen university and general hospitals in the Netherlands. Cognitive function was assessed
in hospitalised patients aged≥65 years old, who were admitted to medical and surgical wards. A Mini-Cog score of<3out of 5 indicated cognitive dysfunction. The attending nurses and physicians were asked whether they suspected
cognitive dysfunction in their patient. Variables associated with recognition of cognitive dysfunction were assessed using multilevel and multivariable logistic regression analyses.

Results: 347 of 757 enrolled patients (46%) showed cognitive dysfunction. Cognitive dysfunction was recognised by attending nurses in 137 of 323 patients (42%) and by physicians in 156 patients (48%). In 135 patients (42%),
cognitive dysfunction was not recognised by either the attending nurse or physician. Recognition of cognitive dys‑function was better at a lower Mini-Cog score, with the best recognition in patients with the lowest scores. Patients
with a Mini-Cog score<3 were best recognised in the geriatric department (69% by nurses and 72% by physicians)

Conclusion: Cognitive dysfunction is common in hospitalised older patients and is poorly recognised by healthcare professionals. This study highlights the need to improve recognition of cognitive dysfunction in hospitalised older
patients, particularly in individuals with less apparent cognitive dysfunction. The high proportion of older patients with cognitive dysfunction suggests that it may be benefcial to provide care tailored to cognitive dysfunction for all
hospitalised older patients.