Does cognitive decline/dementia increase Delirium risk after stroke?

Abstract

Background Delirium is a common contributor to mortality and hospital costs in stroke patients. Different observational studies have showed inconsistent results regarding the association between cognitive decline/dementia and delirium after acute stroke. Therefore, we performed this meta‐analysis with the aim of determining whether cognitive decline/dementia is related to the risk of delirium after acute stroke. Methods We systematically searched PubMed, Embase, Google Scholar, and Web of Science for relevant studies from inception to September 2020. We calculated the pooled odds ratio (OR) with 95% confidence interval (CI) by using fixed or random effects models based on heterogeneity measured by the I2 index. Results The association between cognitive decline/dementia and post‐stroke delirium was examined in 13 studies with 3183 participants. After pooled analysis, we found that cognitive decline/dementia was significantly associated with susceptibility to delirium in post‐stroke patients (OR = 3.70, 95%CI: 2.90–4.71, P < 0.001). Subgroup analysis suggested that cognitive decline/dementia was associated with an increased risk of delirium in Caucasians (OR = 3.73, 95%CI: 2.73–5.11, P < 0.001), non‐Caucasians (OR = 3.65, 95%CI: 2.50–5.33, P < 0.001), samples with <200 subjects (OR = 3.70, 95%CI: 2.17–6.31, P < 0.001), samples with ≥200 subjects (OR = 3.70, 95%CI: 2.82–4.85, P < 0.001), studies published in 1990–2009 (OR = 3.17, 95%CI: 1.48–6.77, P = 0.003), and studies published in 2010–2020 (OR = 3.76, 95%CI: 2.92–4.86, P < 0.001). Conclusions We identified an association between cognitive decline/dementia and the risk of developing delirium. Cognitive decline/dementia may be a promising predictor for delirium in post‐stroke patients.

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