Prevalence and impact of cognitive impairment assessed by Mini-Cog in hospitalized cardiac rehabilitation referrals

Introduction and objectives

Evaluate patients referred for cardiac rehabilitation to determine the prevalence of cognitive impairment (CI) and compare readmission rates and mortality for those with and without CI.

Methods

Patients were retrospectively divided into cohort A (Mini-Cog completed) and cohort B (Mini-Cog not completed). Cohort A was then divided into A₁ (Mini-Cog positive for CI) and A₂ (Mini-Cog negative for CI).

Results

Of 1440 patients, 986 (68%) completed the Mini-Cog (cohort A) and 454 (32%) patients did not (cohort B). Within cohort A, 46 (4.7%) had a positive Mini-Cog (cohort A₁) and 940 (95.3%) had a negative Mini-Cog (cohort A₂). Cohort A₁ had significantly higher rates of all-cause readmission compared with cohorts A₂ and B (63% vs 44% and 47%; P = .02), and significantly higher mortality (28% vs 9% vs 15%; P < .001), but was also significantly older, with more co-morbidities. After accounting for demographic and co-morbidity differences between cohorts A₁ and A₂ using propensity score matching and Cox proportional hazards model, cohort A₁ had significantly increased rates of the composite outcome of readmission and/or death at 3-months (P = .002).

Conclusions

Poor performance on the Mini-Cog identified an older group of phase I cardiac rehabilitation patients that had significantly increased rates of the combined end-point of readmission plus death.