The edition · Geriatrics
The eight-question AD8 now has cut-offs for both mild cognitive impairment and dementia in hospitalised older adults
A crosswalk with the IQCODE gives the brief family interview two thresholds for judging baseline cognition when delirium makes direct testing impossible, dementia did not predict readmission after nursing-home rehabilitation, and activity-limiting back pain was linked to later frailty.
The edition in brief
In 264 hospitalised older adults (JAGS, 24 September 2026), linking the AD8 to the IQCODE produced AD8 cut-offs of 2 for mild cognitive impairment and 4 for dementia, giving clinicians a brief informant tool to estimate baseline cognition when delirium prevents direct testing. In US Health and Retirement Study data linked to Medicare (JAGS, 10 October 2026), 15.8% of 4,527 discharges home after short nursing-home rehabilitation were readmitted within 30 days; dementia was not associated with readmission, while prior hospital use, comorbidity and not being married were. In 2,554 older men from MrOS, activity-limiting back pain was associated with progression from pre-frail to frail seven years later (OR 1.40). A Dutch trial of pilocarpine drops for xerostomia in frail or seriously ill adults missed its primary endpoint but was underpowered. Pearl: review anticholinergic burden in any older adult with a dry mouth.
After short nursing-home rehabilitation, prior hospital use predicted readmission; dementia did not
Target post-rehabilitation discharge support at older adults with heavy prior hospital use, high comorbidity and limited support at home.
Activity-limiting back pain was linked to progression to frailty in older men
Treat activity-limiting back pain in older adults as a possible route to frailty, not just a symptom.
Pilocarpine drops for dry mouth in frail patients missed their primary endpoint in an underpowered trial
Pilocarpine drops for dry mouth in frail patients are unproven; consider a trial only after reviewing causes.
In an older adult with a dry mouth, review the anticholinergic burden first
Treat dry mouth in an older adult as a prompt to review and reduce anticholinergic medicines.
AD8 cut-offs for mild cognitive impairment and dementia help judge baseline cognition in delirium
Use the AD8 with cut-offs of 2 for mild cognitive impairment and 4 for dementia to estimate pre-admission cognition in delirious older inpatients.
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