BACKGROUND: Delirium is believed to constitute a risk factor for dementia, but previous research has failed to satisfactorily take account of the patients' preexisting level of cognitive functioning. METHODS: A prospective 6-month follow-up of 106 elderly hip fracture patients free from prefracture dementia. Delirium was assessed by the Confusion Assessment Method. Caregivers described the patients' prefracture cognition by the Informant Questionnaire on Cognitive Decline in the Elderly, Short Form (IQCODE-SF). Cognition was measured after 6 months, using 5 validated cognitive tests. An expert panel assessed each case as to whether the diagnostic criteria for dementia according to the DSM-IV were fulfilled at baseline and after 6 months. RESULTS: 29/106 patients (27%) developed delirium in the acute phase. In the delirious group, 11/29 (38%) fulfilled the criteria of dementia after 6 months, compared to 5/77 (7%) in the group without delirium (p < 0.001; χ(2) test). Delirium was the strongest predictor of dementia after 6 months (adjusted odds ratio: 10.5; 95% CI: 1.6-70.3). IQCODE-SF score was a nonsignificant risk factor for incident dementia. CONCLUSION: In hip fracture patients free from prefracture dementia, delirium constitutes the main predictor of dementia 6 months later, adjusted for prefracture cognitive decline measured by the IQCODE-SF.
BACKGROUND:Delirium is believed to constitute a risk factor for dementia, but previous research has failed to satisfactorily take account of the patients' preexisting level of cognitive functioning. METHODS: A prospective 6-month follow-up of 106 elderly hip fracturepatients free from prefracture dementia. Delirium was assessed by the Confusion Assessment Method. Caregivers described the patients' prefracture cognition by the Informant Questionnaire on Cognitive Decline in the Elderly, Short Form (IQCODE-SF). Cognition was measured after 6 months, using 5 validated cognitive tests. An expert panel assessed each case as to whether the diagnostic criteria for dementia according to the DSM-IV were fulfilled at baseline and after 6 months. RESULTS: 29/106 patients (27%) developed delirium in the acute phase. In the delirious group, 11/29 (38%) fulfilled the criteria of dementia after 6 months, compared to 5/77 (7%) in the group without delirium (p < 0.001; χ(2) test). Delirium was the strongest predictor of dementia after 6 months (adjusted odds ratio: 10.5; 95% CI: 1.6-70.3). IQCODE-SF score was a nonsignificant risk factor for incident dementia. CONCLUSION: In hip fracturepatients free from prefracture dementia, delirium constitutes the main predictor of dementia 6 months later, adjusted for prefracture cognitive decline measured by the IQCODE-SF.
Authors: Sarinnapha M Vasunilashorn; Dena Schulman-Green; Douglas Tommet; Tamara G Fong; Tammy T Hshieh; Edward R Marcantonio; Eran D Metzger; Eva M Schmitt; Patricia A Tabloski; Thomas G Travison; Yun Gou; Benjamin Helfand; Sharon K Inouye; Richard N Jones Journal: Dement Geriatr Cogn Disord Date: 2020-06-17 Impact factor: 2.959
Authors: Eva M Schmitt; Edward R Marcantonio; David C Alsop; Richard N Jones; Selwyn O Rogers; Tamara G Fong; Eran Metzger; Sharon K Inouye Journal: J Am Med Dir Assoc Date: 2012-09-19 Impact factor: 4.669
Authors: Jennifer K Harrison; David J Stott; Rupert McShane; Anna H Noel-Storr; Rhiannon S Swann-Price; Terry J Quinn Journal: Cochrane Database Syst Rev Date: 2016-11-21
Authors: Piet Eikelenboom; Jeroen Jm Hoozemans; Rob Veerhuis; Eric van Exel; Annemieke Jm Rozemuller; Willem A van Gool Journal: Alzheimers Res Ther Date: 2012-06-04 Impact factor: 6.982
Authors: Jennifer K Burton; Patricia Fearon; Anna H Noel-Storr; Rupert McShane; David J Stott; Terry J Quinn Journal: Cochrane Database Syst Rev Date: 2021-07-19
Authors: Jennifer K Burton; David J Stott; Rupert McShane; Anna H Noel-Storr; Rhiannon S Swann-Price; Terry J Quinn Journal: Cochrane Database Syst Rev Date: 2021-07-18
Authors: Jennifer K Burton; Patricia Fearon; Anna H Noel-Storr; Rupert McShane; David J Stott; Terry J Quinn Journal: Cochrane Database Syst Rev Date: 2021-07-19