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Lookup NU author(s): Dr Sarah Richardson, Dr Rachael LawsonORCiD, Professor Bloss Stephan, Professor Dame Louise Robinson, Professor Fiona MatthewsORCiD, Professor Carol Brayne, Professor John-Paul TaylorORCiD, Emeritus Professor Stuart ParkerORCiD, Dr Louise Allan
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
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 Mini-Mental 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 (i-AGeD>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.
Author(s): Richardson SJ, Lawson RA, Davis D, Stephan B, Robinson L, Matthews FE, Brayne C, Barnes L, Taylor JP, Parker S, Allan LM
Publication type: Article
Publication status: Published
Journal: Age and Ageing
Year: 2021
Volume: 50
Issue: 5
Pages: 1675-1681
Print publication date: 01/09/2021
Online publication date: 03/05/2021
Acceptance date: 13/02/2021
Date deposited: 24/02/2021
ISSN (print): 0002-0729
ISSN (electronic): 1468-2834
Publisher: Oxford University Press
URL: https://doi.org/10.1093/ageing/afab068
DOI: 10.1093/ageing/afab068
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