Cognitive Status of Medicare Beneficiaries Receiving Home Health Care After Cardiac Interventions.

OBJECTIVES

Hundreds of thousands of cardiac interventions are performed in the United States each year. It is unclear if postoperative cognitive function varies between older adults undergoing catheter-based or surgical cardiac interventions. Home health (HH) care provides a unique opportunity to study the cognitive functional status of older adults following cardiac interventions. The objective of this study was to compare the cognitive functional status of Medicare beneficiaries receiving HH care following an interventional procedure for cardiac disease.

DESIGN

This was a retrospective cohort study.

SETTING AND

PARTICIPANTS

Sixty-eight thousand two hundred seventy-eight Medicare fee-for-service beneficiaries aged ≥65 years who received HH care following coronary revascularization, valve interventions, or combined revascularization and valve interventions in the catheterization laboratory or surgical operating room in 2019.

METHODS

Cognitive functional status was assessed using the cognitive function variable included in the HH Outcome and Assessment Information Set. Logistic regression was used to identify predictors of cognitive impairment.

RESULTS

Among beneficiaries, 39.8% of those undergoing catheterization and 22.4% of those undergoing surgery exhibited impaired cognitive function (P < .001). After adjusting for covariates, surgical intervention was associated with lower odds of impairment compared with catheterization (adjusted odds ratio, 0.594; 95% CI, 0.569-0.620).

CONCLUSIONS AND IMPLICATIONS: Cognitive impairment is common among older adults receiving HH care after cardiac interventions, particularly following catheter-based procedures. Observed differences in cognitive functional status between groups may reflect differences in population characteristics rather than intervention type alone. Understanding these patterns may inform strategies to improve outcomes and optimize the role of post-acute care services in the recovery process.