Nonagenarians with major neurocognitive disorder hospitalized in a high-complexity hospital

ABSTRACT The prevalence of neurocognitive disorder increases with age; nearly one in two nonagenarians may be affected, representing a clinical challenge during hospitalization because of their admission condition, comorbidities, decision-making needs, and management. Objective: This study aimed to describe the clinical characteristics of individuals aged 90 years old or older with a history of major neurocognitive disorder admitted due to an acute medical condition. Methods: A descriptive cross-sectional study was conducted using institutional data from the Geriatrics Department of a high-complexity hospital in Bogotá, Colombia. Information on the history and type of neurocognitive disorder was obtained through self-report or proxy report, and disease severity was assessed using information recorded during the comprehensive geriatric assessment. A descriptive analysis was performed to examine clinical characteristics, baseline functional status, and in-hospital outcomes. Results: Among the 178 people, the majority were women (71.34%), with a mean age of 93±3 years, and had polypharmacy. Upon admission, 55.61% had delirium, and among the 68 patients who underwent nutritional assessment, 75.00% had moderate or severe malnutrition. The most frequent diagnoses were urinary tract infection and pneumonia. Alzheimer disease (62.5%) and multiple etiologies (Alzheimer disease and vascular) (6.2%) were the most frequent reported etiologies. The median length of stay was 7 days, 4.49% experienced in-hospital complications such as healthcare-associated pneumonia or bacteremia, 45.51% continued management through a home care plan, and 34.83% completed the planned hospital care. Conclusion: Nonagenarians with major neurocognitive disorder have multiple healthcare needs during hospitalization, requiring multidimensional and interdisciplinary assessment and intervention.