Cognitive function and acute care utilization.

TitleCognitive function and acute care utilization.
Publication TypeJournal Article
Year of Publication2003
AuthorsWalsh, EG, Wu, B, Mitchell, JB, Berkman, LF
JournalJ Gerontol B Psychol Sci Soc Sci
Date Published2003 Jan
ISSN Number1079-5014
Call Numberpubs_2003_Walsh_etal.pdf
KeywordsAged, Cognition Disorders, Female, Geriatric Assessment, Health Behavior, Health Status, Hospitalization, Hospitals, Humans, Length of Stay, Male, Neuropsychological tests, Outpatient Clinics, Hospital, Severity of Illness Index, United States

OBJECTIVES: Little is known about variation in cognitive function across the aged population, or how use and costs of health care vary with cognitive impairment. This study was designed to create a typology of cognitive function in a nationally representative sample, and evaluate acute care use in relation to cognitive function, holding constant confounding factors. By including proxy assessments of cognitive function, this is the first study to include individuals unable to respond themselves.

METHODS: We analyzed the baseline year of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, sponsored by the National Institute on Aging, to create three levels of cognitive function, using direct measures for self-respondents (n = 6,651) and proxy evaluations for the others (n = 792). We used a two-part model to predict the likelihood of using various health services and to evaluate intensity of care among users.

RESULTS: Sixteen percent, 64%, and 20% of the sample fell into the low, moderate, and high cognitive function groups, respectively, that differed significantly on almost all demographic and health status measures, and some utilization measures. Controlling for other health and functional status measures, lower cognitive function had a significant and negative effect on outpatient services, but did not affect hospital use directly.

DISCUSSION: Lower cognitive function may be a barrier to outpatient care, but these analyses should be repeated using administrative use and cost data.

User Guide Notes

Endnote Keywords

Cognitive Function/Health Care Utilization

Endnote ID


Alternate JournalJ Gerontol B Psychol Sci Soc Sci
Citation Key6898
PubMed ID12496307
Grant List1R03AG15708-01 / AG / NIA NIH HHS / United States