Dataset Information

Altered Mental Status: An Important but Overlooked Presenting Symptom of COVID-19 in Older Adults.

ABSTRACT:

Objectives

To determine whether altered mental status (AMS) as a presenting symptom in older adults with COVID-19 is independently associated with adverse outcomes.

Methods

A retrospective single center observational study of admitted patients (n = 421) age greater than 60 and a positive COVID-19 test. Outcomes included mortality, intubation, acute respiratory distress syndrome, acute kidney injury, and acute cardiac injury. Multivariate regression analysis was used to determine if presenting with AMS was associated with adverse outcomes.

Results

There was an increased risk of mortality (RR 1.29, 95% CI 1.05-1.57), intubation (RR 1.52, 95% CI 1.09-2.12) and AKI (RR 1.42, 95% CI 1.13-1.78) in patients that presented with AMS.

Conclusions

During a global pandemic, prognostic indicators are vital to help guide the clinical course of patients, reduce healthcare cost, and preserve life. Our study suggests that AMS can play a major role in diagnostic algorithms in older adults with COVID-19.

SUBMITTER: Oommen A

PROVIDER: S-EPMC8196474 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

Altered Mental Status: An Important but Overlooked Presenting Symptom of COVID-19 in Older Adults.

Oommen Alvin A Thomas Joel J Parmar Priyanka P Rosengarten Sabrina S Wilson Clara C Maini Rohan R Kim Julie Minjae JM Mecklenburg Max M Daniel Pia P Brietman Igal I

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 20210612 11

<h4>Objectives</h4>To determine whether altered mental status (AMS) as a presenting symptom in older adults with COVID-19 is independently associated with adverse outcomes.<h4>Methods</h4>A retrospective single center observational study of admitted patients (n = 421) age greater than 60 and a positive COVID-19 test. Outcomes included mortality, intubation, acute respiratory distress syndrome, acute kidney injury, and acute cardiac injury. Multivariate regression analysis was used to determine i ...[more]

PMID: 34257003

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Project description:IntroductionCognitive impairment may make stroke and heart attack symptom recognition difficult, potentially resulting in treatment delays for those with these cardiovascular diseases (CVDs). Despite cognitive impairment affecting large numbers of older US adults who are also at increased risk of stroke and heart attack, little is known about stroke and heart attack symptom recognition in this population. As a result, this study sought to determine the impact of cognitive impairment on stroke and heart attack symptom recognition among older US adults.MethodsUsing the 2014 and 2017 National Health Interview Surveys, we compared stroke and heart attack symptom recognition levels in US adults aged ≥65 years with cognitive impairment and those without cognitive impairment. Estimates of stroke and heart attack symptom recognition adjusted for CVD-related factors were assessed by cognitive impairment status. We also conducted analyses stratified by living arrangement and stroke and heart attack history for individuals with and without cognitive impairment.ResultsUS adults aged ≥65 years with cognitive impairment were observed to be 3.0-6.7% and 1.6-4.9%, respectively, less likely to recognize an individual stroke and heart attack symptom than similarly aged individuals without cognitive impairment. Recognition of all 5 stroke/heart attack symptoms was also lower among those with cognitive impairment, with this group being 9.7% less likely to recognize all stroke symptoms and 6.7% less likely to recognize all 5 heart attack symptoms compared to people without cognitive impairment. Following adjustment, individuals with cognitive impairment continued to have slightly lower recognition of certain individual stroke and heart attack symptoms as well as of all 5 symptoms of these conditions (stroke OR: 0.70 [95% CI: 0.58-0.85]; heart attack OR: 0.88 [95% CI: 0.75, 1.03]) than those without cognitive impairment. For individuals with cognitive impairment, living with others was linked with slightly better recognition of all individual stroke symptoms and heart attack history with better recognition of all individual heart attack symptoms.ConclusionsAdditional work is needed to address the challenge of improving recognition levels for specific stroke and heart attack symptoms in older US adults with cognitive impairment and especially for members of this group who live alone.

Dataset Information

Altered Mental Status: An Important but Overlooked Presenting Symptom of COVID-19 in Older Adults.

Objectives

Methods

Results

Conclusions

Publications

Altered Mental Status: An Important but Overlooked Presenting Symptom of COVID-19 in Older Adults.

Similar Datasets

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