A two-minute cognitive score predicts a year of a patient's life after head injury

The edition in brief

A retrospective cohort of 14,395 Medicare beneficiaries aged 65 and over, hospitalised with traumatic brain injury between 2017 and 2020 and discharged to a skilled nursing facility, linked their Brief Interview for Mental Status score on admission to days spent at home over the following year. Nearly half (47.1%) were cognitively intact, 30.2% had moderate impairment and 22.7% severe impairment. Adjusted for beneficiary and facility characteristics, moderate impairment carried a rate ratio of 0.82 (95% CI 0.78 to 0.87) for days at home and severe impairment 0.64 (0.60 to 0.68) — a clean dose-response across a test that takes about two minutes. An intercept survey of 315 New Yorkers aged 65 and over found 22.2% reported cannabis use in the past year and 11.1% of those in the past 24 hours; among users, 32.9% met criteria for cannabis use disorder and 5.7% for severe disorder. The commonest reasons given were to get high (60.0%), relieve tension (55.7%), sleep (52.9%) and relieve chronic pain (30.0%), and current cigarette smokers had over three times the odds of use (aOR 3.73, 95% CI 1.65 to 8.48). In 686 participants of the US POINTER sleep ancillary study, longer napping measured by actigraphy was associated with slower processing speed (beta -0.0973, 95% CI -0.1664 to -0.0282), with no evidence that sleep apnoea modified the relationship. Across 340,509 Medicare beneficiaries with dementia, hospital adoption of AI risk-prediction tools was associated with lower readmissions and preventable admissions, while treatment-recommendation tools were associated with higher out-of-pocket spending.