Risk for Decline Up for Low-Income Seniors After ICU Stay

Risks for disability and transition to probable dementia increased after ICU stay for seniors with dual eligibility for Medicare and Medicaid

TUESDAY, March 8, 2022 (HealthDay News) — Community-dwelling older adults with dual eligibility for Medicare and Medicaid have an increased risk for decline in function and cognition after intensive care unit (ICU) hospitalization, according to a study published online March 8 in the Annals of Internal Medicine.

Snigdha Jain, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues examined the association between socioeconomic disadvantage and decline in function, cognition, and mental health among older survivors of an ICU hospitalization in a retrospective analysis involving community-dwelling older adults in the National Health and Aging Trends Study. Having dual-eligible Medicare-Medicaid status was a measure of socioeconomic disadvantage.

The researchers found that dual eligibility was associated with a significant increase in disability after ICU hospitalization after accounting for sociodemographic and clinical characteristics (incidence rate ratio, 1.28; 95 percent confidence interval, 1.00 to 1.64) and with significantly increased odds of transitioning to probable dementia (odds ratio, 9.79; 95 percent confidence interval, 3.46 to 27.65). There was no association observed for dual eligibility with symptoms of depression and anxiety after ICU hospitalization (incidence rate ratio, 1.33; 95 percent confidence interval, 0.99 to 1.79).

“Dual-eligible older persons are at greater risk for functional and cognitive decline after an ICU hospitalization,” the authors write. “These findings highlight the need to prioritize low-income seniors in rehabilitation and recovery efforts after critical illness.”