Johannes Baltasar Hessler1, Monika Brönner2, Thorleif Etgen3, Othmar Gotzler4, Hans Förstl5, Holger Poppert6, Dirk Sander7, Horst Bickel8. 1. Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: johannes.hessler@lrz.tum.de. 2. Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: m.broenner@mnet-online.de. 3. Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany; Department of Neurology, Kliniken Südostbayern-Klinikum Traunstein, Cuno-Niggl-Strasse 3, 83278 Traunstein, Germany. Electronic address: thorleif@etgen.de. 4. INVADE Study Group, Karl-Böhm-Strasse 32, 85598 Baldham, Germany. Electronic address: gotzler-med@t-online.de. 5. Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: hans.foerstl@lrz.tum.de. 6. Department of Neurology, Technische Universität München Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: poppert@gmx.de. 7. Department of Neurology, Benedictus Krankenhaus Tutzing, Bahnhofstrasse 5, 82327 Tutzing, Germany. Electronic address: d.sander@mac.com. 8. Department of Psychiatry and Psychotherapy, Technische Universität München Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: h.bickel@lrz.tum.de.
Abstract
OBJECTIVES: To investigate the association between smoking in the older population and the risk of inpatient delirium, which is common and has adverse consequences. METHOD: Participants (N=3754) were insurants aged ≥55years of the largest German statutory health insurance company, who enrolled in a 6-year prospective population-based study. Baseline smoking, adjusted for age, sex, depressive symptoms, cognitive impairment and alcohol consumption, was analyzed as risk factor of inpatient delirium. Results are presented as hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: Three-hundred seventy-three (10.0%) participants were smokers at baseline, 865 (23.0%) were quitters and 2516 (67.0%) were lifelong abstainers. Mean pack-years of smokers and quitters were 23.8 (S.D.=22.4). Sixty-one (1.6%) received a diagnosis of inpatient delirium. Smokers had an increased risk of delirium compared to abstainers in the fully adjusted model (HR=2.87, 95% CI 1.24-6.66). Quitters and abstainers did not differ (HR=0.79, 95% CI 0.37-1.72). Comparing smokers and quitters, current smoking status (HR=3.22, 95% CI 1.20-8.62) but not pack-years [residual χ(2)(1)=0.25, P=.874] were associated with inpatient delirium. CONCLUSION: Only current smoking but not being a quitter and the lifetime amount smoked were associated with inpatient delirium, indicating that acute nicotine withdrawal may represent a relevant pathogenic mechanism.
OBJECTIVES: To investigate the association between smoking in the older population and the risk of inpatient delirium, which is common and has adverse consequences. METHOD:Participants (N=3754) were insurants aged ≥55years of the largest German statutory health insurance company, who enrolled in a 6-year prospective population-based study. Baseline smoking, adjusted for age, sex, depressive symptoms, cognitive impairment and alcohol consumption, was analyzed as risk factor of inpatient delirium. Results are presented as hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: Three-hundred seventy-three (10.0%) participants were smokers at baseline, 865 (23.0%) were quitters and 2516 (67.0%) were lifelong abstainers. Mean pack-years of smokers and quitters were 23.8 (S.D.=22.4). Sixty-one (1.6%) received a diagnosis of inpatient delirium. Smokers had an increased risk of delirium compared to abstainers in the fully adjusted model (HR=2.87, 95% CI 1.24-6.66). Quitters and abstainers did not differ (HR=0.79, 95% CI 0.37-1.72). Comparing smokers and quitters, current smoking status (HR=3.22, 95% CI 1.20-8.62) but not pack-years [residual χ(2)(1)=0.25, P=.874] were associated with inpatient delirium. CONCLUSION: Only current smoking but not being a quitter and the lifetime amount smoked were associated with inpatient delirium, indicating that acute nicotine withdrawal may represent a relevant pathogenic mechanism.
Authors: Shervin Assari; James Smith; Ritesh Mistry; Mehdi Farokhnia; Mohsen Bazargan Journal: Int J Environ Res Public Health Date: 2019-05-23 Impact factor: 3.390
Authors: Shervin Assari; James L Smith; Marc A Zimmerman; Mohsen Bazargan Journal: Int J Environ Res Public Health Date: 2019-04-04 Impact factor: 3.390
Authors: Mohsen Bazargan; James L Smith; Paul Robinson; John Uyanne; Ruqayyah Abdulrahoof; Chika Chuku; Shervin Assari Journal: Int J Environ Res Public Health Date: 2019-05-17 Impact factor: 3.390