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

Abstract

Introduction and objectivesEvaluate 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. MethodsPatients 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). ResultsOf 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). ConclusionsPoor 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.