Delirium Is an Important Predictor of Incident Dementia among Elderly Hip Fracture Patients

Krogseth, Maria; Wyller, Torgeir Bruun; Engedal, Knut; Juliebø, Vibeke

doi:10.1159/000322591

Cited by 87 publications

(81 citation statements)

References 73 publications

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“…For example, when elderly patients become delirious during infections, treatment of the infection may go well but the patients emerge with dementia. Similar observations have been made after postoperative delirium in elderly hip fracture patients free from preexisting dementia [97,98]. Other studies have shown that new episodes of cognitive decline in AD cases were concomitant to systemic inflammatory events [99,100].…”

Section: The Microglia Priming Hypothesissupporting

confidence: 72%

Uncovering the Path to Neurodegeneration from Playingfield to Battlefield

Baas¹,

Ramaglia²

2014

Traumatic Brain Injury

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Section: The Microglia Priming Hypothesissupporting

confidence: 72%

Uncovering the Path to Neurodegeneration from Playingfield to Battlefield

Baas¹,

Ramaglia²

2014

Traumatic Brain Injury

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“…However, over the 48-hour observation period we collected several sources of information, so this error is probably negligible. Another potential source of misclassification bias relates to the criteria used to define SSD in a population like ours, very complex and with a high prevalence of cognitive impairment and dementia (there may be an overlap of symptoms between SSD and dementia) and delirium is an important predictor of incident dementia [28]. There could also be a possible overlap of symptoms between SSD and dementia.…”

Section: Discussionmentioning

confidence: 94%

Different Functional Outcomes in Patients with Delirium and Subsyndromal Delirium One Month after Hospital Discharge

Velilla

Bouzón

Cambra³

et al. 2012

Dement Geriatr Cogn Disord

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Background: Subsyndromal delirium has an increasing relevance in the medical literature. There are only three studies in hospitalized elderly patients. Our goal is to demonstrate the importance of this syndrome in a population with more complexity and cognitive impairment than in previous studies. Methods: Prospective multicentre study in three tertiary hospitals. The health outcomes recorded in the follow-up at 1 month were the persistence of delirium, hospital readmission, discharge destination, death, Barthel index and the Delirium Rating Scale Revised 98. To assess the impact of delirium in the Barthel index at 30 days, we adjusted univariate and multivariate linear regression models. Results: 85 patients were enrolled; 75.3% of the patients had at least 1 positive item in the Confusion Assessment Method; 45 patients (53%) were diagnosed with delirium and 19 (22.3%) with subsyndromal delirium (SSD). The 30-day risk of death was associated with lower levels of albumin (p = 0.021) and the Cumulative Illness Rating Scale in Geriatrics (CIRS-G; p = 0.003). Adjusting for CIRS-G and the initial Barthel index, the diagnosis of delirium appears to be related to a lower Barthel index at 30 days (p = 0.019), showing a significant linear gradient (p < 0.005). Conclusion: SSD could help get more accurate diagnoses as well as improve patient management.

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“…With 402 patients included in this prospective, observational study, the number of patients investigated is large compared with that of other single-center studies on this topic [20,33,34]. The predominantly female cohort included in this series is typical for a geriatric patient population with a comparatively high ASA score at hospital admission [35,36,37].…”

Section: Discussionmentioning

confidence: 99%

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Bliemel

Lechler

Oberkircher

et al. 2015

Dement Geriatr Cogn Disord

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Objective: To examine the influence of cognitive impairment on the functional outcomes and complication rates of patients with hip fracture during in-patient treatment. Methods: A total of 402 patients who were surgically treated for hip fractures were consecutively enrolled at a single trauma center. The patients were grouped according to their results on the Mini-Mental State Examination (MMSE), i.e., ≥20 points (group I) and ≤19 points (group II). Complication and in-hospital mortality rates as well as postoperative functional outcomes according to the Barthel Index (BI) were compared between the groups. A multivariate regression analysis was performed to control for additional factors. Results: 33% of the patients had MMSE scores ≤19 points. The complication rates were similar between the groups (p > 0.05). Likewise, the overall in-hospital mortality rates were similar between the patients in group I (4.5%) and those in group II (9.8%; β = 0.218, p < 0.740). Functional outcomes, as assessed by the BI, were lower in group II (β = -0.266, p < 0.001). The patients in group II were transferred to a rehabilitation clinic less frequently (52.3 vs. 76.0%, p < 0.001). Conclusions: Patients with lower MMSE scores are at a higher risk for poorer functional outcomes. Perioperative care should focus on the preservation of functional abilities to protect these patients from an additional loss of independence and disadvantageous clinical course.

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Delirium Is an Important Predictor of Incident Dementia among Elderly Hip Fracture Patients

Cited by 87 publications

References 73 publications

Uncovering the Path to Neurodegeneration from Playingfield to Battlefield

Uncovering the Path to Neurodegeneration from Playingfield to Battlefield

Different Functional Outcomes in Patients with Delirium and Subsyndromal Delirium One Month after Hospital Discharge

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

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