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Dementia / Cognition Disorders · Journal article
International Journal of Nursing Studies · June 17, 2026
Encouraging direction, but not yet definitive.
Among 3009 older Swedish adults without dementia followed for up to 16 years, those with cognitive impairment no dementia had significantly higher risk of avoidable hospitalization (HR 1.18) but not non-avoidable hospitalization, and experienced first avoidable hospitalization 1.11 years earlier. Formal care use substantially attenuated the avoidable hospitalization risk (HR 0.62), suggesting care coordination may reduce preventable acute events in this population.
Population-based prospective cohort study. Swedish older adults aged ≥60 years at baseline, free from dementia at enrolment, from the Swedish National study on Aging and Care in Kungsholmen. Intervention: Cognitive impairment, no dementia (diagnosed by neuropsychological testing), formal care use, and informal care use. Compared with: Cognitively intact participants (no cognitive impairment, no dementia). n = 3,009. Sweden (Kungsholmen study).
701 (23.3%) participants had cognitive impairment, no dementia at baseline Cognitive impairment, no dementia associated with higher risk of overall avoidable hospitalization (HR 1.18, 95% CI 1.01–1.37) No significant association between cognitive impairment, no dementia and non-avoidable hospitalization (HR 0.99, 95% CI 0.90–1.09)
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Clinicians should recognize that older adults with mild cognitive impairment (no dementia) face elevated risk of preventable hospitalizations, particularly from chronic conditions. Investment in formal care coordination and timely outpatient disease management for this population may substantially reduce avoidable hospitalization burden.
Population-based cohort study with 16-year follow-up showing cognitive impairment without dementia is associated with increased avoidable hospitalization risk, with a protective effect of formal care; results are clinically relevant but limited by observational design and modest effect sizes.
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Quoted from the source exactly as published.
Clinicians should recognize that older adults with mild cognitive impairment (no dementia) face elevated risk of preventable hospitalizations, particularly from chronic conditions. Investment in formal care coordination and timely outpatient disease management for this population may substantially reduce avoidable hospitalization burden.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. Dementia is associated with higher rates of hospitalization. However, it remains unclear whether cognitive impairment, no dementia is associated with increased risk of avoidable hospitalizations that can be prevented with timely and effective outpatient care and non-avoidable hospitalizations, which are less amenable to prevention. We aimed to examine the association of cognitive impairment, no dementia with hospitalizations and time to first hospitalization and further explore whether care use may modulate this association.Methods. From the Swedish National study on Aging and Care in Kungsholmen, 3009 older adults free from dementia (aged ≥60 years at baseline) were followed for up to 16 years to detect hospitalizations. Cognitive impairment, no dementia was diagnosed based on a neuropsychological test battery. Hospitalizations were identified through the National Patient Register and categorized as avoidable hospitalizations (overall and due to chronic or acute conditions) or non-avoidable hospitalizations. Information on formal and informal care use at baseline was obtained through interviews. Data were analyzed using flexible parametric survival models and Laplace regression models.Results. At baseline, 701 (23.3%) participants had cognitive impairment, no dementia. Over the follow-up (median 10.78 [IQR 4.57-13.75] years), 877 (29.2%) and 2257 (75.0%) experienced avoidable hospitalizations and non-avoidable hospitalizations. Cognitive impairment, no dementia was related to higher risk of overall avoidable hospitalization (HR 1.18, 95% CI 1.01-1.37) with similar directions for avoidable hospitalization due to chronic (HR 1.16, 95% CI 0.96-1.39) and acute (HR 1.12, 95% CI 0.89-1.42) conditions, although slightly attenuated. There was no significant association between cognitive impairment, no dementia and non-avoidable hospitalization (HR 0.99, 95% CI 0.90-1.09). People with cognitive impairment, no dementia experienced their first avoidable hospitalization 1.11 years (95% CI -2.07,-0.15) earlier and first non-avoidable hospitalization 0.86 years (95% CI -1.54,-0.18) earlier compared to cognitively intact participants. In stratified analysis, the association between cognitive impairment, no dementia and avoidable hospitalization was buffered by formal (HR 0.62, 95% CI 0.44-0.88) care use.Conclusions. Our findings suggest that people free from dementia but with mild cognitive symptoms were at higher risk of avoidable hospitalization, emphasizing the importance of comprehensive disease management in outpatient care. Formal care use appeared to attenuate this risk, highlighting the need for accessible and coordinated care services tailored to cognitive impairment, even in its mild forms.
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