It has been estimated that up to what percentage of older patients experience some cognitive impairment during acute medical or surgical hospitalization?

• A. 10-20%
• B. 30-40%
• C. 90-100%
• D. 60-80%

Answer: (D)

Acute hospitalization is a major stressor for the aging brain, and cognitive changes—especially delirium—are very common in older adults. Factors like infection, dehydration, hypoxia, polypharmacy, metabolic disturbances, pain, sleep disruption, and sensory barriers all interact to impair cognition during a hospital stay. Because of these multifactorial influences, a large proportion of older patients experience some cognitive impairment while acutely ill or recovering from surgery. The range that best fits this high prevalence is sixty to eighty percent, reflecting that while not every patient becomes cognitively impaired, more than half often does, and in many settings the rate approaches eight in ten. This underscores the importance of routine cognitive screening on admission and ongoing delirium prevention and management throughout the hospital stay. Effective strategies include reorientation, ensuring proper hydration and pain control, minimizing deliriogenic medications, promoting sleep, and encouraging early mobilization, with objective tools like CAM-ICU or 4AT used to detect delirium.