Dementia Worsened By Delerium Often Caused By Hospital Stays, Surgery: Study

Elderly patients who experience delirium, often as a result of hospitalization or post-operative side effects, may face a higher risk of suffering dementia, according to the findings of new research. 

In a study published this month in the medical journal JAMA Psychiatry, researches from the U.K. found that delirium events accelerate the cognitive decline of dementia, raising concerns about episodes that often occur among elderly patient when hospitalized.

Researchers evaluated 987 autopsied brains from three population-based studies. Participants from Finland and the U.K. agreed to donate their brains after death, and to have their memory and thinking abilities recorded for five to 10 years before their deaths.

The autopsies were performed from Jan 1, 1985 through December 31, 2011, with all episodes of delirium, dementia and Alzheimer’s recorded. Participants underwent neuropathological assessments.

While patients who had dementia and those that experienced delirium had cognitive declines, measured by Mini-Mental State Examination (MMSE); patients who experienced both delirium and dementia had much faster cognitive declines than other patients.

Patients who had delirium experienced a cognitive decline of 0.37 MMSE points per year. Patients who had dementia experienced a decline of 0.39 MMSE points per year.

However, the patients who had both delirium and dementia had the greatest cognitive decline at 0.72 MMSE points per year; a decline rate faster than those with only one factor.

Delirium causes a confused and disoriented mental state. It affects one-quarter of elderly patients and often goes unrecognized in patients because of busy hospitals, patient transfers and changing staffs.

Delirium is often caused by severe illness, medication, infection, surgery, or alcohol and drug withdrawal. Early symptoms include an inability to stay focused, poor memory, rambling, restlessness, agitation, and disturbed sleep habits.

Dementia is one of many conditions that involves cognitive impairment. It often results in memory loss, personality changes, and problems communicating. It can seriously impact the quality of a person’s life.

“Our results indicate that delirium interacts with underlying pathologic processes of classic dementia and so represents a potential independent but interrelated pathologic pathway to chronic cognitive impairment and dementia,” the researchers concluded. “If delirium prevention could lead to consequent prevention of dementia, it will be essential to understand whether certain dimensions of the delirium syndrome might have a greater effect on cognitive trajectories than others.”

Dementia affects more than 47 million people worldwide costing the healthcare system more than $1 trillion. About 60% of dementia cases are caused by Alzheimer’s disease.

Researchers emphasized the importance of hospitals increasing efforts to diagnose patients with delirium. They call for a focus on early delirium treatment to help delay or reduce cases of dementia.