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  • Title: High risk of cognitive and functional decline after postoperative delirium. A three-year prospective study.
    Author: Bickel H, Gradinger R, Kochs E, Förstl H.
    Journal: Dement Geriatr Cogn Disord; 2008; 26(1):26-31. PubMed ID: 18577850.
    Abstract:
    BACKGROUND/AIMS: The aim of the study was to investigate the association of postoperative delirium with the outcomes of cognitive impairment, functional disability and death. METHODS: Hip surgery patients aged 60 years or over (n = 200) underwent preoperative and daily postoperative assessment of their cognitive status during hospital stay. Outcome variables were determined at an average of 8 and 38 months after discharge from hospital. RESULTS: Fourty-one patients developed postoperative delirium. Delirium was a strong independent predictor of cognitive impairment and the occurrence of severe dependency in activities of daily living. The associations were more marked for the long- than for the short-term outcome. Thirty-eight months after discharge from hospital, 53.8% of the surviving patients with postoperative delirium suffered from cognitive impairment, as compared to only 4.4% of the nondelirious participants. Logistic regression analysis adjusted for age, sex, medical comorbidity and preoperative cognitive performance revealed highly significant associations between delirium and cognitive impairment (OR = 41.2; 95% CI = 4.3-396.2), subjective memory decline (OR = 6.2; 95% CI = 1.5-25.8) and incident need for long-term care (OR = 5.6; 95% CI = 1.6-19.7). CONCLUSION: The present study confirms a poor prognosis after delirium in elderly patients. The findings suggest that delirium does not simply persist for a certain time but also predicts a future cognitive decline with an increased risk of dementia.
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