Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs

Age Ageing. 2013 Sep;42(5):582-8. doi: 10.1093/ageing/aft074. Epub 2013 Jun 25.


Background: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission.

Methods: a follow-up study of 250 patients aged over 70 admitted to 1 of 12 wards (geriatric, medical or orthopaedic) of an English acute general hospital with a co-morbid mental health problem and followed up at 180 days.

Results: twenty-seven per cent did not return to their original place of residence after the hospital admission. After 180 days 31% had died, 42% had been readmitted and 24% of community residents had moved to a care home. Only 31% survived without being readmitted or moving to a care home. However, 16% spent >170 of the 180 days at home. Significant predictors for poor outcomes were co-morbidity, nutrition, cognitive function, reduction in activities of daily living ability prior to admission, behavioural and psychiatric problems and depression. Only 42% of survivors recovered to their pre-acute illness level of function. Clinically significant behavioural and psychiatric symptoms were present at follow-up in 71% of survivors with baseline cognitive impairment, and new symptoms developed frequently in this group.

Conclusions: the variable, but often adverse, outcomes in this group implies a wide range of health and social care needs. Community and acute services to meet these needs should be anticipated and provided for.

Keywords: general hospital; mental health; older people; outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / psychology*
  • Cognition
  • Comorbidity
  • Delivery of Health Care, Integrated
  • Emergency Service, Hospital*
  • England / epidemiology
  • Female
  • Homes for the Aged
  • Hospitals, General
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / mortality
  • Mental Disorders / psychology*
  • Mental Disorders / therapy
  • Mental Health*
  • Nursing Homes
  • Patient Admission*
  • Patient Discharge
  • Patient Readmission
  • Prognosis
  • Risk Factors
  • Survivors / psychology*
  • Time Factors