Cognitive impairment and malnutrition, predictors of all-cause mortality in hospitalized elderly subjects with cardiovascular disease

Background. - In the elderly, cognitive impairment is associated with loss of independence and may be predictive of mortality. Aims. - Our aim was to determine if cognitive impairment correlated to poor prognosis in an elderly (>70 years) hospitalized population with cardiovascular diseases. Our other goal was to explore other factors that might influence mortality risk. Better understanding of these factors should help practitioners select tools to assess these patients and prevent the occurrence of adverse outcomes. Methods. - During 4 years of follow-up, medical events and all-cause mortality were reported in 331 patients aged above 70 years, as well as clinical and biological variables and Mini Mental State Examination scores. Results. - Patients with cognitive impairment were older and had a lower body mass index than patients without cognitive impairment (P=0.023). When all factors were forced into the Cox model, cognitive impairment remained an independent predictor of mortality (P < 0.001). High plasma glucose, low body mass index and low plasma albumin were associated with overall mortality, independent of cognitive impairment. Conclusion. - In elderly inpatients aged above 70 years with cardiovascular diseases, cognitive impairment and malnutrition are associated, and both are predictors of all-cause mortality. Early nutrition programmes may help to delay mortality, as well as screening the impairment of neuropsychological functioning using the total Mini Mental State Examination score. (C) 2013 Elsevier Masson SAS. All rights reserved.