Aetiological diagnosis of cognitive impairment in older adults: The role of geriatric nursing and factors associated with its detection.

AIMS: To quantify the proportion of residents with cognitive impairment who receive an aetiological diagnosis during their stay in nursing homes, to identify associated sociodemographic and stay-related factors, and to evaluate the association between geriatric specialist availability and aetiological diagnosis

METHODS

Retrospective observational cohort study with up to 24 months of follow-up across eight nursing homes in Pontevedra, Spain. Participants were aged ≥60 years, had cognitive impairment at admission and no prior aetiological diagnosis (n = 98). The primary outcome was receipt of an aetiological diagnosis during the stay.

RESULTS

An aetiological diagnosis was recorded in 26/98 residents (26.5%). Among those diagnosed, dementia accounted for 69.2%; vascular dementia predominated (55.5%), followed by Alzheimer's disease (22.2%); in 22.2% the subtype was not recorded. Median length of stay was longer in residents who received a diagnosis (24 vs 5.5 months; p < 0.01). In bivariate analyses, the presence of a geriatric nurse and a geriatrician was associated with a greater likelihood of receiving an aetiological diagnosis.

CONCLUSIONS

Only one quarter of residents with cognitive impairment received an aetiological diagnosis during their stay, indicating considerable scope for improvement. Longer length of stay and the presence of healthcare professionals specialised in geriatrics were associated with higher diagnostic rates.