Cited by 404Intensive Care Unit Cognitive DisordersDementia and Cognitive Impairment ResearchAlcoholism and Thiamine Deficiency

The inter-relationship between delirium and dementia: the importance of delirium prevention

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Fong, Tamara G., Inouye, Sharon K.·2022·Nature Reviews Neurology

Abstract

Delirium and dementia are two frequent causes of cognitive impairment among older adults and have a distinct, complex and interconnected relationship. Delirium is an acute confusional state characterized by inattention, cognitive dysfunction and an altered level of consciousness, whereas dementia is an insidious, chronic and progressive loss of a previously acquired cognitive ability. People with dementia have a higher risk of developing delirium than the general population, and the occurrence of delirium is an independent risk factor for subsequent development of dementia. Furthermore, delirium in individuals with dementia can accelerate the trajectory of the underlying cognitive decline. Delirium prevention strategies can reduce the incidence of delirium and associated adverse outcomes, including falls and functional decline. Therefore, delirium might represent a modifiable risk factor for dementia, and interventions that prevent or minimize delirium might also reduce or prevent long-term cognitive impairment. Additionally, understanding the pathophysiology of delirium and the connection between delirium and dementia might ultimately lead to additional treatments for both conditions. In this Review, we explore mechanisms that might be common to both delirium and dementia by reviewing evidence on shared biomarkers, and we discuss the importance of delirium recognition and prevention in people with dementia.

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  • Experiencing delirium, a sudden and transient state of confusion common in hospitalized older adults, has been linked to long-term cognitive decline and dementia.

    “Furthermore, experiencing delirium — a sudden and transient state of confusion common in hospitalized older adults — has been linked to long‐term cognitive decline and dementia.”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [230]

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  1. [2]Wilson JE Delirium Nat. Rev. Dis. Prim. 2020 6 90 33184265 PMC9012267
  2. [35]Kratz T Heinrich M Schlauß E Diefenbacher A Preventing postoperative delirium Dtsch. Arztebl Int. 2015 112 289 296 26008890 PMC4452898
  3. [45]Galvin JE The AD8: a brief informant interview to detect dementia Neurology 2005 65 559 564 16116116
  4. [144]Schnitker L Prevention of delirium in older adults with dementia: a systematic literature review J. Gerontol. Nurs. 2020 46 43 54 32852044
  5. [165]National Institute for Health and Care Excellence. Delirium: Prevention, Diagnosis and Management (NICE, 2019). 31846262

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Authors
Fong, T. G., & Inouye, S. K.
Affiliations
Beth Israel Deaconess Medical Center (US)
Corresponding author
Fong, Tamara G.
Venue
Nature Reviews Neurology
Published
2022-08-26
Volume
18
Issue
10
Pages
579-596
ISSN
  • 1759-4758 (ISSN-L)
  • 1759-4766
OpenAlex
W4293116166
Cited by
404
References
176
Citations by year
2026: 113 · 2025: 120 · 2024: 105 · 2023: 64 · 2022: 2
FWCI
15.11
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Neurology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
Keywords
delirium, dementia, delirium prevention, cognitive impairment, older adults, cognitive decline, falls, functional decline, shared biomarkers, pathophysiology, delirium detection
MeSH terms
Aged, Delirium, Dementia, Humans, Biomarkers, Incidence, Cognitive Dysfunction

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