Delirium among elderly persons admitted to a psychiatric hospital: clinical course during the acute stage and one‐year follow‐up

Koponen, Hannu; Stenbäck, Ulla; Mattila, Esa; Soininen, Hilkka; Reinikainen, Kari; Riekkinen, Paavo

doi:10.1111/j.1600-0447.1989.tb10306.x

Cited by 111 publications

(80 citation statements)

References 28 publications

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“…Almost all existing studies used IQCODE, 32,3,18 BDRS 6 , mini-mental, 6,13,14,16,18 chart review, and unspecified interviews 4,14,16 to measure cognitive performance. As we know, these methods may not discriminate between grades of cognitive impairment.…”

Section: Study Limitationsmentioning

confidence: 99%

“…6,14,17,18 Others have demonstrated that the occurrence of delirium may increase the incidence of dementia, even in patients without evidence of previous cognitive impairment. 4,13,16 A recent review of literature, including nine studies selected by means of methodological criteria, associated delirium with either a greater cognitive decline or higher incidence of dementia. 31 We believe that the difference observed in the present study results simply from the differences between the samples studied.…”

Section: Functional and Cognitive Lossesmentioning

confidence: 99%

“…3 Several studies have found associations between the presence of delirium and a poor prognosis for functional recovery, increased mortality, increased length of hospital stay, increased institutionalization following discharge, and increased incidence of dementia. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In the present study, we re-evaluated patients, assessed during their hospitalization due to femoral fracture, four years after discharge. Groups with and without delirium were compared in terms of mortality and functional and cognitive evolution.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Delirium on Mortality and Cognitive and Functional Performance Among Elderly People With Femoral Fractures

Furlaneto

Leme

2007

Clinics

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Furlaneto ME, Garcez-Leme LE. Impact of delirium on mortality and cognitive and functional performance among elderly people with femoral fractures. Clinics. 2007;62(5):545-52. OBJECTIVE:To evaluate the evolution of cognitive and functional performance and mortality among elderly patients who were delirious during hospitalization due to femoral fracture. who did not present with delirium. There were six deaths, and 97 patients were discharged from the hospital. We obtained information on 85 of these patients four years after discharge; 42 patients were still alive and 43 had died at the time of the evaluation. METHODS: Data on vital status was obtained for 85 patients. For the 42 survivors, we acquired information on their basic activities of daily living (ADL), instrumental activities of daily living (IADL), and cognitive performance (BDRS) by means of telephone interview with the same caregivers who had provided information at the time of the hospitalization. We compared this data with that obtained during their hospitalizations four years prior. For the 43 patients who died, we obtained information regarding their deaths and used this data in the analysis of mortality. RESULTS: No relationships were observed between delirium and mortality, delirium and cognitive loss, or delirium and functional loss, after four years from discharge of elderly patients with hip fractures. An initial cognitive deficit was a predictor for mortality (RR = 2.54; p = 0.016), functional loss (OR = 1.80; p = 0.027) and cognitive loss (OR = 1.53; p = 0.024). Cognitive loss was also related to age. CONCLUSIONS: Delirium had no impact on mortality or functional or cognitive losses in long term evolution (2 years) among elderly patients with femoral fractures. An initial cognitive impairment may identify patients at risk of mortality, functional and cognitive losses over the long term evolution.

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Section: Study Limitationsmentioning

confidence: 99%

Section: Functional and Cognitive Lossesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Delirium on Mortality and Cognitive and Functional Performance Among Elderly People With Femoral Fractures

Furlaneto

Leme

2007

Clinics

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“…Nine were done on surgical patients, 12,19-26 11 on medical patients, 13,27-36 2 on a mixed population of medical and surgical patients, 37,38 and 5 on psychiatric patients. [39][40][41][42][43] Two of these latter studies looked at patients receiving electroconvulsive therapy. 42,43 A total of 1,365 cases of delirium were studied with 5,513 control subjects ( Table 1).…”

Section: Articles Selected and Datamentioning

confidence: 99%

“…42,43 A total of 1,365 cases of delirium were studied with 5,513 control subjects ( Table 1). The subjects in Marcantonio et al 12,23 and Koponen et al [39][40][41] were counted only once because the same population of cases was analyzed looking at different risk factors. The number of delirium cases per study varied from 8 to 301 with a mean of 59.…”

Section: Articles Selected and Datamentioning

confidence: 99%

Delirium risk factors in elderly hospitalized patients

et al. 1998

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OBJECTIVE: Delirium is frequent in elderly hospitalized patients. Many studies have examined its risk factors, but results have been quite variable. Thus, the goal of this study is to identify through systematic literature review the risk factors associated with the development of delirium in hospitalized geriatric patients. MEASUREMENTS AND MAIN RESULTS:First, MEDLINE / CURRENT CONTENTS databases were screened for relevant articles published from 1966 to December 1995, and from bibliographies of identified articles additional reports were selected. Second, the reports were screened by two different investigators and retained only if meeting the five following criteria: (1) original research in French or English; (2) prospective study; (3) patients over age 50; (4) minimum of one risk factor examined; (5) acceptable definition of delirium. Third, the methodology of each study was graded according to specific criteria for risk factor studies. Fourth, risk factors were identified and tabulated, unadjusted odds ratios (ORs) were computed, and where appropriate a combined OR with the Mantel-Haenszel estimator was calculated. Twenty-seven articles were retained meeting all of the above criteria. Among these studies, 11 were done on medical patients, 9 on surgical patients, 2 on medical and surgical patients, and 5 on psychiatric patients. In total 1,365 subjects with delirium were studied. Sixty-one different risk factors were examined, the five most common being dementia, medication, medical illness, age, and male gender. Mantel-Haenszel estimator was calculated for 10 risk factors, the most strongly associated being dementia (OR 5.2; 95% confidence interval [CI] 4.2, 6.3), medical illness (OR 3.8; 95% CI 2.2, 6.4), alcohol abuse (OR 3.3; 95% CI 1.9, 5.5), and depression (OR 1.9; 95% CI 1.3, 2.6). Methodologic weaknesses were present in many studies.

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Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients

Levkoff¹

1992

Archives of Internal Medicine

359

319

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Delirium among elderly persons admitted to a psychiatric hospital: clinical course during the acute stage and one‐year follow‐up

Cited by 111 publications

References 28 publications

Impact of Delirium on Mortality and Cognitive and Functional Performance Among Elderly People With Femoral Fractures

Impact of Delirium on Mortality and Cognitive and Functional Performance Among Elderly People With Femoral Fractures

Delirium risk factors in elderly hospitalized patients

Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients

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