Undiagnosed long-term cognitive impairment in acutely hospitalised older medical patients with delirium: a prospective cohort study
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BACKGROUND: delirium and dementia are common in the general hospital, being present in nearly 50% of older unselected admissions to hospital. Cognitive impairment is a risk factor for delirium, but the prevalence of previously undiagnosed cognitive impairment (dementia or mild cognitive impairment) in patients with delirium is unknown. METHODS: we performed a prospective cohort study of people over 70 years admitted to hospital with delirium to establish the prevalence of previously unrecognised prior cognitive impairment. Delirium was diagnosed at baseline using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Mild cognitive impairment and dementia were diagnosed 3 months following recruitment in survivors using the International Working Group on Mild Cognitive Impairment criteria and DSM-IV criteria, respectively. RESULTS: delirium was identified in 17.9% of older patients, and 82 participants with delirium were assessed at 3 months: 5 (6%) had persistent delirium, 14 (17%) had mild cognitive impairment and 47 (57%) had dementia. In 17 participants with prior dementia and 14 with prior mild cognitive impairment, the diagnosis had been unrecognised, amounting to 31/82 (38%) of all patients with delirium having some form of previously undiagnosed cognitive impairment. CONCLUSION: given that over 1/3 of older patients with delirium were found to have a previously undiagnosed cognitive impairment, the development and evaluation of services to follow-up and manage patients with delirium are warranted.
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No intervention has successfully reduced the number of hospital admissions of community-dwelling people with dementia, although education, exercise, rehabilitation, and telemedicine have reduced admissions for older people without dementia.
“However, no intervention has successfully reduced number of hospital admissions of community-dwelling people with dementia,276 although education, exercise, rehabilitation, and telemedicine have reduced admissions for older people without dementia.277”
From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [276]
Citation 276 is attached to the claim about interventions for community-dwelling people with dementia; the comparison with older people without dementia has a separate citation. The Background discusses dementia among hospital admissions, and the Discussion considers identifying dementia during a hospital stay, but neither reports whether interventions reduce admissions among community-dwelling people with dementia. Searches for admission-prevention interventions and readmissions found no passage addressing that claim. (LLM, conf=0.76)
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Cites
Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014) · The Lancet · doi:10.1016/s0140-6736(13)60688-1 · Cited by 3,722 · see citing works
Witlox, J., Eurelings, L. S. M., de Jonghe, J. F. M., Kalisvaart, K. J., Eikelenboom, P., & van Gool, W. A. (2010) · JAMA · doi:10.1001/jama.2010.1013 · Cited by 1,972 · see citing works
Mitchell, A. J., & Shiri‐Feshki, M. (2009) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01326.x · Cited by 1,659 · see citing works
Occurrence and outcome of delirium in medical in-patients: a systematic literature review
Siddiqi, N., House, A. O., & Holmes, J. D. (2006) · Age and Ageing · doi:10.1093/ageing/afl005 · Cited by 1,185 · see citing works
Ellis, G., Whitehead, M. A., Robinson, D., O'Neill, D., & Langhorne, P. (2011) · BMJ · doi:10.1136/bmj.d6553 · Cited by 1,068 · see citing works
Delirium Predicts 12-Month Mortality
McCusker, J., Cole, M. G., Abrahamowicz, M., Primeau, F. J., & Belzile, É. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.4.457 · Cited by 682 · see citing works
Dementia in the acute hospital: prospective cohort study of prevalence and mortality
Sampson, E. L., Blanchard, M. R., Jones, L., Tookman, A. J., & King, M. (2009) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.108.055335 · Cited by 598 · see citing works
Ahmed, S., Leurent, B., & Sampson, E. L. (2014) · Age and Ageing · doi:10.1093/ageing/afu022 · Cited by 463 · see citing works
Delirium in an adult acute hospital population: predictors, prevalence and detection
Ryan, D. J., O’Regan, N., Ó’Caoimh, R., Clare, J., O’Connor, M., Leonard, M. M., Mcfarland, J. W., Tighe, S., O’Sullivan, K., Trzepacz, P. T., et al. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-001772 · Cited by 461 · see citing works
The risk of dementia and death after delirium
Rockwood, K. J. (1999) · Age and Ageing · doi:10.1093/ageing/28.6.551 · Cited by 410 · see citing works
McCusker, J., Cole, M. G., Dendukuri, N., Belzile, É., & Primeau, F. (2001) · Europe PMC (PubMed Central) · Cited by 391 · see citing works
Detection of delirium in the acute hospital
Collins, N., Blanchard, M. R., Tookman, A. J., & Sampson, E. L. (2009) · Age and Ageing · doi:10.1093/ageing/afp201 · Cited by 211 · see citing works
Morandi, A., Davis, D. H. J., Fick, D. M., Turco, R., Boustani, M. A., Lucchi, E., Guerini, F., Morghen, S., Torpilliesi, T., Gentile, S., et al. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.12.084 · Cited by 158 · see citing works
Self-citationGoldberg, S. E., Bradshaw, L. E., Kearney, F. C., Russell, C., Whittamore, K. H., Foster, P. E. R., Mamza, J., Gladman, J. R. F., Jones, R. G., Lewis, S. A., et al. (2013) · BMJ · doi:10.1136/bmj.f4132 · Cited by 156 · see citing works
Self-citationMecocci, P., Strauss, E. I. V., Cherubini, A., Ercolani, S., Mariani, E., Senin, U., Winblad, B. G., & Fratiglioni, L. (2005) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000087440 · Cited by 124 · see citing works
New horizons in the pathogenesis, assessment and management of delirium
MacLullich, A. M. J., Anand, A., Davis, D. H. J., Jackson, T., Barugh, A., Hall, R. J., Ferguson, K. J., Meagher, D. J., & Cunningham, C. M. (2013) · Age and Ageing · doi:10.1093/ageing/aft148 · Cited by 122 · see citing works
Self-citationFrequency of delirium and subsyndromal delirium in an adult acute hospital population
Meagher, D. J., O’Regan, N., Ryan, D. J., Connolly, W., Boland, E., Ó’Caoimh, R., Clare, J., Mcfarland, J. W., Tighe, S. M., Leonard, M. M., et al. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.139865 · Cited by 100 · see citing works
Sampson, E. L., Leurent, B., Blanchard, M. R., et al. (2012) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3919 · Cited by 90 · see citing works
Kaźmierski, J., Banyś, A., Latek, J., Bourke, J. H., Jaszewski, R., Sobów, T., & Kłoszewska, I. (2014) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000357454 · Cited by 81 · see citing works
Whittamore, K. H., Goldberg, S. E., Gladman, J. R. F., et al. (2013) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3961 · Cited by 61 · see citing works
Self-citationJackson, T., Naqvi, S. H., & Sheehan, B. (2013) · Age and Ageing · doi:10.1093/ageing/aft145 · Cited by 56 · see citing works
Self-citationPharmacological Treatment of Dementia: A Scoping Review of Systematic Reviews
van de Glind, E. M. M., van Enst, W. A., Munster, B. C. V., Rikkert, M. G. M. O., Scheltens, P., Scholten, R. J. P. M., & Hooft, L. (2013) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000353892 · Cited by 55 · see citing works
Enzymes of drug metabolism during delirium
White, S. V., Calver, B. L., Newsway, V., Wade, R., Patel, S., Bayer, A. J., & O'Mahony, M. S. (2005) · Age and Ageing · doi:10.1093/ageing/afi189 · Cited by 44 · see citing works
Dementia in acute hospital inpatients: the role of the geriatrician
Russ, T. C., Shenkin, S. D., Reynish, E., Ryan, T., Anderson, D., & MacLullich, A. M. J. (2012) · Age and Ageing · doi:10.1093/ageing/afs048 · Cited by 37 · see citing works
Self-citationThe National Dementia strategy in England
Burns, A. S., & Robert, P. H. (2009) · BMJ · doi:10.1136/bmj.b931 · Cited by 33 · see citing works
Cameron launches challenge to end "national crisis" of poor dementia care
Kmietowicz, Z. (2012) · BMJ · doi:10.1136/bmj.e2347 · Cited by 33 · see citing works
Tay, L. B. G., Chan, M. P. C., & Chong, M. S. (2013) · Journal of Hospital Medicine · doi:10.1002/jhm.2035 · Cited by 12 · see citing works
Laurila, J. V., Pitkälä, K. H., Strandberg, T. E., et al. (2008) · The Journals of Gerontology Series A · doi:10.1093/gerona/63.10.1124 · Cited by 12 · see citing works
Presentation and Clinical Management of Dementia
Bayer, A. J. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-6231-8.10052-2 · Cited by 9 · see citing works
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Research works printed but not linked: 1
- Woodhouse HMFR, editor. Brocklehurst's Textbook of Geriatric Medicine and Gerontology (seventh Edition). Philadelphia: W.B. Saunders; 2010. p. 392-401.
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Dementia prevention, intervention, and care: 2020 report of the Lancet Commission
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30367-6 · Cited by 10,430 · see citing works
RetractedChallenges and opportunities in understanding dementia and delirium in the acute hospital
Jackson, T. A., Gladman, J. R. F., Harwood, R. H., MacLullich, A. M. J., Sampson, E. L., Sheehan, B., & Davis, D. H. J. (2017) · PLOS Medicine · doi:10.1371/journal.pmed.1002247 · Cited by 99 · see citing works
Self-citation
- Authors
- Jackson, T. A., MacLullich, A. M. J., Gladman, J. R. F., Lord, J. M., & Sheehan, B.
- Affiliations
- Queen Elizabeth Hospital Birmingham (GB)
- Edinburgh Royal Infirmary (GB)
- University of Nottingham (GB)
- University of Birmingham (GB)
- John Radcliffe Hospital (GB)
- Corresponding author
- Jackson, Thomas A.
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-04-13
- Volume
- 45
- Issue
- 4
- Pages
- 493-499
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2337699821
- Cited by
- 66
- References
- 29
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 10 · 2023: 2 · 2022: 4 · 2021: 11 · 2020: 8 · 2019: 8 · 2018: 5 · 2017: 6
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Repository@Nottingham (University of Nottingham) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Research into Ageing Fund
- Age UK
- British Geriatrics Society (367)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- delirium, dementia, mild cognitive impairment, older medical patients, hospitalized older adults, prevalence
- MeSH terms
- Cognitive Aging, Mental Status and Dementia Tests, Frailty, Age Factors, Aged, Aged, 80 and over, Cognition, Delirium, Dementia, England, Female, Hospitalization, Humans, Male, Predictive Value of Tests, Prognosis, Prospective Studies, Time Factors, Geriatric Assessment, Prevalence, Frail Elderly, Cognitive Dysfunction
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