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OBJECTIVES: To determine the effect of clinical presentation and cognitive changes on the postdischarge outcome in older adult patients with West Nile fever (WNF).

DESIGN: Retrospective, cohort analysis.

SETTING: Meir Hospital located in the center of Israel in the Sharon region.

PARTICIPANTS: Thirty‐two patients aged 65 and older hospitalized during a WNF outbreak.

MEASUREMENTS: All patients' charts were analyzed retrospectively with special emphasis on their cognitive and functional state. A follow‐up examination of patients with functional decline at discharge was performed after 3 months.

RESULTS: A change in consciousness, rather than in cognition, predicted the outcome. The death rate was 22% (7/32); all fatal cases were aged 78 and older. Similarly, the functional decline and residual damage appeared only in the older age group (≥75). Eighty‐eight percent of the survivors returned to their …