Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature

Can J Aging. 2021 Sep;40(3):405-423. doi: 10.1017/S0714980820000355. Epub 2021 Apr 12.


Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.

Keywords: acute care; aging; bed blocking; cognitive disorders; delayed discharge; durée du séjour; déficits cognitifs; length of stay; soins aigus; vieillissement.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction* / epidemiology
  • Critical Care*
  • Databases, Factual
  • Hospitals
  • Humans
  • Length of Stay