Characteristics and outcomes of hospitalized older adults admitted for medical reasons at university teaching hospitals in Rwanda

Older patients represent a growing and particularly vulnerable population in Rwandan hospitals, often requiring significant healthcare resources due to multiple and complex health issues. However, there is limited local evidence on their clinical characteristics and hospital outcomes. This cross-sectional study assessed 190 older patients (over 60 years) admitted for medical reasons at CHUK and CHUB from February to April 2021. Using convenience sampling, participants from the internal medicine wards, intensive care unit, and emergency department were evaluated for their nutritional status (Mini Nutritional Assessment), cognitive function (Ottawa 3DY), depression (Geriatric Depression Scale), and independence level (Katz ADL). Demographic and other clinical data were extracted from patient hospital records. Data was analyzed using STATA v16, with descriptive statistics and logistic regression identifying mortality risk factors at a 95% confidence interval (p < 0.05). In this three-month study, 190 older patients (mean age 72.8 SD: 8.7 years) were enrolled at the two hospitals, with 59.5% being female. The leading causes of admission were malignant neoplasms (21.5%), pneumonia (18.4%), and stroke (11.5%), with non-communicable diseases responsible for 71.5% of admissions. Malnutrition was prevalent (47.3%), as was cognitive dysfunction (45%) and depression (30.4%). In multivariate analysis, the inhospital mortality was independently associated with malnutrition (aOR = 16.403, 95% CI: 1.101–244.33, p = 0.042), malignant neoplasms (aOR = 3.861, 95% CI: 1.062–14.040, p = 0.04), and chronic kidney disease (aOR = 9.418, 95% CI: 1.767–50.195, p = 0.009). Older patients comprise nearly one-third of medical admissions at major Rwandan hospitals, with numbers expected to rise as life expectancy increases. Non-communicable diseases drive hospitalizations with high mortality rates. Malnutrition, malignancies, and chronic kidney disease independently predict mortality, with malnutrition carrying the highest risk. These findings highlight the urgent need for age-friendly hospital care models, improved chronic disease management and targeted nutritional support services.