Delirium could accelerate cognitive decline in people with dementia

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Here is a great dementia resource for caregivers and healthcare professionals,

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The Dementia Caregiver's Little Book of Hope [Kindle Edition

Alzheimer's Society

 
 

Published 18 January 2017

A study, published today (Wednesday 18 January 2017) in the journal JAMA Psychiatry, is the first to show that delirium can worsen cognitive decline in people with dementia.

The new research was carried out by UCL and the University of Cambridge and was funded by the Wellcome Trust.

When hospitalised, people can become very confused and disorientated. This condition is known as delirium and affects a quarter of older patients. This study finds delirium may have long-lasting consequences, including accelerating declines in memory and thinking caused by dementia. 

Researchers looked at three populations in Finland, Cambridge and the UK, examining brain specimens in 987 people over the age of aged 65. Each person's memory, thinking and experience of delirium had been recorded over 10 years towards the end of their life.

People who had experienced delirium or who had dementia-related changes in their brains showed greater declines in memory and thinking performance than those without. However, those with dementia-related changes who also experienced delirium had the most severe declines in their cognition over the 10 years prior to death.

Dr Clare Walton, Research Manager at Alzheimer's Society said:

'Delirium is a temporary state of confusion and disorientation that is quite common among older people, especially those in hospital or living with dementia.

'Growing evidence shows that a case of delirium can predict worsening memory and thinking problems or the onset of dementia. This study suggests that delirium is not just a result of dementia-related changes in the brain but might independently cause problems with cognition. We don't understand why yet, but future research should look at the long term impact of delirium on the brain.

'We often hear of people who have developed memory and thinking problems or dementia after a stay in hospital. Understanding how delirium is involved and whether it can be prevented or treated is a pressing issue.'

Worries about dementia: How hospitalization affects the elderly

Caregivers and healthcare professionals, here is some great information

Here is a great dementia resource for caregivers and healthcare professionals,

Your residents will love the Amazon Kindle Fire

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care  professionals to get an easyceu or two

Follow alzheimersideas on twitter

The Dementia Caregiver's Little Book of Hope [Kindle Edition

Medical Xpress

Older people often worry about dementia and while some risks are known, for example alcoholism or stroke, the effects of illness are less clear. New research published in BioMed Central's open access journal Critical Care looks at illness requiring hospitalization and treatment in the intensive care unit (ICU) and finds that infection or severe sepsis, neurological dysfunction, such as delirium, or acute dialysis are all independently associated with an increased risk of a subsequent diagnosis of dementia.

This study was based on a random 5% of older (66 years or above) Medicare patients who were treated in intensive care in 2005 and whose health was followed for a further three years using Medicare claims data. Of the 25,368 patients included in the study 4,519 (17.8%) went on to receive a diagnosis of dementia during the three year follow up period. Patients with previous indications of cognitive impairment for whom dementia could have been an escalation of a pre-existing condition were excluded from the study. Increasing age was very strongly associated with diagnosis of dementia following ICU. The risk at 75 was more than double that of the 66 to 69 year olds. And this rose to more than five times the risk for those age 85 and older. Women had a marginally higher risk than men and, as other studies have shown, race was also important to risk. Length of stay in ICU was not a factor nor was the need for mechanical ventilation. Three factors related to the critical illness were independently associated with an increased risk of a diagnosis of dementia: a critical illness with the presence of an infection which increased to a higher risk with more severe infection such as severe sepsis, having acute neurologic dysfunction during critical illness, including anoxic brain damage, encephalopathy, and transient mental disorders, and finally acute renal failure requiring dialysis. This last risk was time-dependent and only increased the risk 6 months after the patient had been discharged from hospital. Dr Hannah Wunsch, from Columbia University Medical Center, lead author of the study commented, "Due to increasing life spans and better hospital care, millions of older people now survive a critical illness every year. Our study provides a greater understanding of the consequences of these hospitalizations on subsequent risk of receiving a diagnosis of dementia, and may allow for better planning and targeting future studies to high risk populations." More information: Risk factors for dementia after critical illness in elderly Medicare beneficiaries Carmen Guerra, Walter T Linde-Zwirble and Hannah Wunsch Critical Care (in press) Journal reference: Critical Care