Delirium in older adults is associated with development of new dementia: a systematic review and meta‐analysis

Objectives Observational studies have examined the association between delirium and development of new dementia. However, no recent review has collectively assessed the available evidence quantitatively and qualitatively. We systematically reviewed and critically evaluated the literature regarding t...

Full description

Saved in:
Bibliographic Details
Published inInternational journal of geriatric psychiatry Vol. 36; no. 7; pp. 993 - 1003
Main Authors Pereira, Jarett Vanz‐Brian, Aung Thein, May Zin, Nitchingham, Anita, Caplan, Gideon A.
Format Journal Article
LanguageEnglish
Published England Wiley Subscription Services, Inc 01.07.2021
Subjects
Online AccessGet full text

Cover

Loading…
More Information
Summary:Objectives Observational studies have examined the association between delirium and development of new dementia. However, no recent review has collectively assessed the available evidence quantitatively and qualitatively. We systematically reviewed and critically evaluated the literature regarding the association between delirium and dementia, and calculated the odds of developing new dementia after having delirium. Methods This systematic review and meta‐analysis was conducted according to Preferred reporting items for systematic reviews and meta‐analyses guidelines. MEDLINE, EMBASE and PsycINFO, were searched for English‐language articles that compared the incidence of new dementia in older adult (≥65) inpatients with delirium, to inpatients without delirium. A random effects model was used for meta‐analysis, and overall effect size was calculated using reported raw data of event counts. The Newcastle‐Ottawa Quality Assessment scale assessed risk of bias. Results Six observational studies met eligibility criteria, with follow‐up times ranging from six months to five years. Four looked at hip fracture surgical patients; one was on cardiac surgery patients and one examined geriatric medical patients. All studies excluded patients with pre‐existing dementia. Pooled meta‐analysis revealed that older adult inpatients who developed delirium had almost twelve times the odds of subsequently developing new dementia compared to non‐delirious patients (OR = 11.9 [95% CI: 7.29–19.6]; p < 0.001). Conclusions Older adult inpatients who develop delirium are at significant risk of subsequently developing dementia. This emphasises the importance of delirium prevention and cognitive monitoring post‐delirium. The included studies mainly examined post‐surgical patients—further research on medical and intensive care unit cohorts is warranted. Future studies should assess whether delirium duration, severity and subtype influence the risk of developing dementia. Key Points Older adult patients who develop delirium in hospital have a drastic twelve‐fold increase in the odds of subsequently developing new dementia Delirium should be considered a medical emergency, given the significant mortality and morbidity associated with it. Prevention strategies are of paramount importance Few studies have examined the association between delirium and development of dementia, and their generalisability is limited to post‐surgical patients. Most of the included studies were assessed to be at low risk of bias, and all controlled for pre‐existing dementia
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-Review-4
content type line 23
ObjectType-Undefined-3
ISSN:0885-6230
1099-1166
DOI:10.1002/gps.5508