Cerebrospinal Fluid β‐Amyloid and Tau Are Not Associated with Risk of Delirium: A Prospective Cohort Study in Older Adults with Hip Fracture

Witlox, Joost; Kalisvaart, Kees J.; Jonghe, Jos F. M. de; Verwey, Nicolaas A.; Stijn, Mireille F. M. van; Houdijk, Alexander P. J.; Traast, Han S.; MacLullich, Alasdair M.J.; Gool, Willem A. van; Eikelenboom, Piet

doi:10.1111/j.1532-5415.2011.03482.x

Cited by 50 publications

(76 citation statements)

References 37 publications

(48 reference statements)

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“…In a cohort of 76 individuals admitted for emergency hip fractures, levels of Aβ1-42, tau, and phosphorylated-tau from CSF were not associated with delirium status, nor did they correlate significantly with IQCODE score, despite a strong association of postoperative delirium with premorbid cognitive decline (as measured by IQCODE). 75 Given the limited sample size, however, the results must be interpreted with caution.…”

Section: Evidence Linking Delirium and Dementiamentioning

confidence: 99%

The interface between delirium and dementia in elderly adults

Fong

Davis

Growdon

et al. 2015

The Lancet Neurology

476

390

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Delirium and dementia are two of the most common causes of cognitive impairment in older populations, yet their interrelationship remains poorly understood. Previous studies have documented that dementia is the leading risk factor for delirium; and delirium is an independent risk factor for subsequent dementia. However, a major area of controversy is whether delirium is simply a marker of vulnerability to dementia, whether the impact of delirium is solely related to its precipitating factors, or whether delirium itself can cause permanent neuronal damage and lead to dementia. Ultimately, it is likely that all of these hypotheses are true. Emerging evidence from epidemiological, clinicopathological, neuroimaging, biomarker, and experimental studies provide support for a strong interrelationship and for both shared and distinct pathological mechanisms. Targeting delirium for new preventive and therapeutic approaches may offer the sought-after opportunity for early intervention, preservation of cognitive reserve, and prevention of irreversible cognitive decline in ageing.

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Section: Evidence Linking Delirium and Dementiamentioning

confidence: 99%

The interface between delirium and dementia in elderly adults

Fong

Davis

Growdon

et al. 2015

The Lancet Neurology

476

390

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“…Age, gender*, dementia*, comorbidity*, opioids Witlox et al 2011 [36], N = 76 40% Age*, cognitive* and functional impairment Nie et al 2012 [37] …”

Section: Resultsmentioning

confidence: 99%

Risk factors of delirium in elderly patients with hip fracture

Suwanpasu

Grinslade

et al. 2014

Asian Biomedicine

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Background: Delirium is a leading cause of death and disability in the elderly with hip fracture. Identifying reliable risk factors for delirium is critical to support optimal outcomes for prevention and reducing delirium. Objective: To quantify the reported factors associated to delirium for patients with hip fracture. Methods: Electronic databases were searched (including Medline, Pub Med, CINAHL, EMBASE, Evidence Based Medicine Reviews, Cochrane Review, Web of Science, and PsycINFO) to identify all studies, published in English language that evaluated the risk factors of delirium hospitalized people with hip fracture. Two reviewers independently assessed methodology quality and extracted relevant data. The data from the included studies were summarized, and pooled estimates were calculated for 12 risk factors. Results: Thirty-seven studies were included in the review and 25 in the meta-analysis. The incidence of delirium was 32.4% (95% confidence interval [CI] = 25.9%-39.5%). Six predisposing and four precipitating factors predicted delirium among older patients with hip fracture confirmed. The predisposing factors included advanced age (ES = 1.06, 95% CI = 1.03-1.09), male sex (ES = 1.34, 95% CI = 1.08-1.68), impairment of cognition (ES = 2.91, 95% CI = 1.91-4.42), and function (ES = 1.75, 95% CI = 1.39-2.2), comorbidity (ES = 1.59, 95% CI = 1.30-1.96), and health problems (ES = 2.64, 95% CI = 2.04-3.42). Precipitating factors were hypo-or hypernatremia (ES = 1.73, 95% CI = 1.14-2.64), depression (ES = 4.07, 95% CI = 1.95-8.49), more than three prescribed drugs (ES = 1.28, 95% CI = 1.10-1.49), and drugs including opioids (ES = 2.13, 95% CI = 1.42-3.18) and anticholinergic agents (ES = 2.10, 95% CI = 1.60-2.75). Conclusion:This meta-analysis result provides evidence that these risk factors have a significant impact on delirium in elders with hip fracture during hospitalization. Developing formal screening, and effective preventive and management strategies for delirium is important.

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“…It is well-recognized that delirium is associated with increased morbidity and mortality, increased length of hospitalization, higher health care costs, and significant distress in patients, family members, and professional caregivers. [1][2][3][4] The presence of delirium can interfere with the recognition and control of physical and psychological symptoms such as pain. 5,6 Delirium is often under-recognized or misdiagnosedinpatientswithcancer;evenwhenrecognized, it frequently goes untreated or is inappropriately treated.…”

Section: Introductionmentioning

confidence: 99%

Evidence-Based Treatment of Delirium in Patients With Cancer

Breitbart

Alici

2012

JCO

153

114

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Delirium is the most common neuropsychiatric complication seen in patients with cancer, and it is associated with significant morbidity and mortality. Increased health care costs, prolonged hospital stays, and long-term cognitive decline are other well-recognized adverse outcomes of delirium. Improved recognition of delirium and early treatment are important in diminishing such morbidity. There has been an increasing number of studies published in the literature over the last 10 years regarding delirium treatment as well as prevention. Antipsychotics, cholinesterase inhibitors, and alpha-2 agonists are the three groups of medications that have been studied in randomized controlled trials in different patient populations. In patients with cancer, the evidence is most clearly supportive of short-term, low-dose use of antipsychotics for controlling the symptoms of delirium, with close monitoring for possible adverse effects, especially in older patients with multiple medical comorbidities. Nonpharmacologic interventions also appear to have a beneficial role in the treatment of patients with cancer who have or are at risk for delirium. This article presents evidence-based recommendations based on the results of pharmacologic and nonpharmacologic studies of the treatment and prevention of delirium.

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Cerebrospinal Fluid β‐Amyloid and Tau Are Not Associated with Risk of Delirium: A Prospective Cohort Study in Older Adults with Hip Fracture

Cited by 50 publications

References 37 publications

The interface between delirium and dementia in elderly adults

The interface between delirium and dementia in elderly adults

Risk factors of delirium in elderly patients with hip fracture

Evidence-Based Treatment of Delirium in Patients With Cancer

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