Background
Acute hospitalisation and delirium have individually been shown to adversely
affect trajectories of cognitive decline but have not previously been considered
together. This work aimed to explore the impact on cognition of hospital
admission with and without delirium, compared to a control group with no
hospital ...
Background
Acute hospitalisation and delirium have individually been shown to adversely
affect trajectories of cognitive decline but have not previously been considered
together. This work aimed to explore the impact on cognition of hospital
admission with and without delirium, compared to a control group with no
hospital admissions.
Methods
The Delirium and Cognitive Impact in Dementia (DECIDE) study was nested
within the Cognitive Function and Ageing Study II (CFAS II)–Newcastle cohort.
CFAS II participants completed two baseline interviews, including the MiniMental State Examination (MMSE). During 2016, surviving participants from
CFAS II–Newcastle were recruited to DECIDE on admission to hospital.
Participants were reviewed daily to determine delirium status.
During 2017, all DECIDE participants and age, sex and years of education
matched controls without hospital admissions during 2016 were invited to
repeat the CFAS II interview. Delirium was excluded in the control group using
the Informant Assessment of Geriatric Delirium Scale (i-AGeD). Linear mixed
effects modelling determined predictors of cognitive decline.
Results
During 2016, 82 of 205 (40%) DECIDE participants had at least one episode of
delirium. At one-year, 135 of 205 hospitalised participants completed an
interview along with 100 controls. No controls experienced delirium (iAGeD>4). Delirium was associated with a faster rate of cognitive decline
compared to those without delirium (β=-2.2, p<0.001), but number of hospital
admissions was not (p=0.447).
Conclusions
These results suggest that delirium during hospitalisation rather than
hospitalisation per se is a risk factor for future cognitive decline, emphasising
the need for dementia prevention studies that focus on delirium intervention.