Long-Term Impact of Delirium on Dementia-Related Mental Decline
Authors of an article published in JAMA Psychiatry assert that delirium may have far-reaching consequences, including speeding up or increasing the effects of dementia (published online ahead of print January 18, 2017; doi:10.1001/jamapsychiatry.2016.3423).
The study, by researchers from the University College of London and the University of Cambridge, is the first to show the multiplying effects of delirium and dementia in older, hospitalized patients. The specific objective of the study was to examine whether the accelerated cognitive decline observed after delirium is independent of the pathologic process of classic dementia.
To investigate this association, scientists led by Daniel Davis, PhD, MRCP, affiliated with both institutions, studied data from 987 people aged 65 years and older from Finland and the United Kingdom. Each person’s memory, cognition, and experience of delirium had been recorded over 10 years toward the end of their life, and brain specimens were collected after death.
The researchers found that people with pathology abnormalities due to both delirium and dementia had the most severe changes in memory.
Dr Davis said in an article, “If delirium is causing brain injury in the short and long-term, then we must increase our efforts to diagnose, prevent, and treat delirium. Ultimately, targeting delirium could be a chance to delay or reduce dementia.”
These findings, according to the researchers, also suggest that episodes of delirium in people who are not known to have dementia might reveal early markers of dementia. They said further research is needed to understand exactly how delirium interacts with dementia and how this could be blocked.
Dr Davis concluded: “Unfortunately, most delirium goes unrecognised. In busy hospitals, a sudden change in confusion may not be noticed by hospital staff. Patients can be transferred several times and staff often switch over—it requires everyone to ‘think delirium’ and identify that a patient’s brain function has changed.”—Amanda Del Signore
