Delirium increases dementia risk and mortality in older patients

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Mar 27 2024BMJ

Delirium is simply a beardown consequence facet for dementia and decease among older people, finds nan largest study of its benignant published by The BMJ today. 

The findings show that, among infirmary patients pinch astatine slightest 1 section of delirium, nan consequence of receiving a caller dementia test was 3 times higher than for patients without delirium and each further section of delirium accrued that consequence by 20%. 

The researchers opportunity their findings support nan mentation that delirium has a beardown independent effect connected dementia consequence successful this objective population.

Delirium is simply a abrupt alteration successful a person's accustomed intelligence state. Symptoms see agitation, disorder aliases being incapable to enactment focused erstwhile awake. Delirium is overmuch much communal successful infirmary patients and older people. 

Previous observational studies person suggested an relation betwixt delirium and consequent dementia, but study limitations time off nan size and quality of this narration unclear.

Yet arsenic nan world load of dementia increases, it is of captious value to corroborate nan grade to which delirium is simply a perchance modifiable consequence factor.

To effort and reside these uncertainties, researchers successful Australia analysed information from 626,467 patients aged 65 years and older pinch nary dementia test who were admitted to infirmary successful New South Wales betwixt January 2009 and December 2014.

Of these patients, 55,211 had astatine slightest 1 recorded section of delirium and were matched to different 55,211 patients without delirium by age, sex, frailty, logic for being successful hospital, magnitude of enactment successful infirmary and magnitude of enactment successful nan intensive attraction unit.

These 110,422 patients (average property 83; 52% women) were past followed-up for 5 years to spot really galore of them were diagnosed pinch dementia.

Collectively, 58% (63,929) of patients died and 17% (19,117) had a recently reported dementia test complete nan follow-up period.

The researchers recovered that patients pinch delirium had a 39% higher consequence of decease and 3 times nan consequence of being diagnosed pinch dementia than patients without delirium.

The narration betwixt delirium and dementia was stronger successful men than women and each further section of delirium was associated pinch a 20% accrued consequence of processing dementia (a dose-response relationship).

These are observational findings, truthful cannot found cause, and nan authors admit that infirmary information whitethorn not beryllium wholly accurate. Nor tin they norm retired nan anticipation that different unmeasured factors whitethorn person affected their results.

However, this was a large, well-designed study pinch a agelong follow-up period, and results were akin aft further analyses to trial nan spot of nan associations, suggesting that they are robust.

"While our results are accordant pinch nan presumption that delirium plays a causative portion successful dementia, they are not conclusive owing to nan basal limitations of observational studies successful determining causality," they write. "Nevertheless, nan results of this study supply valuable insights because prospective randomized controlled tests are improbable to beryllium conducted."

"Delirium is simply a facet that could triple a person's consequence of dementia. Therefore, delirium prevention and curen are opportunities to trim dementia load globally," they conclude.

Source:

Journal reference:

Gordon, E. H., et al. (2024) Delirium and incident dementia successful infirmary patients successful New South Wales, Australia: retrospective cohort study. BMJ. doi.org/10.1136/bmj-2023-077634.