Delirium and the risk of developing dementia: a cohort study of 12 949 patients

Leighton, S. P. , Herron, J. W. , Jackson, E., Sheridan, M., Deligianni, F. and Cavanagh, J. (2022) Delirium and the risk of developing dementia: a cohort study of 12 949 patients. Journal of Neurology, Neurosurgery and Psychiatry, 93(8), pp. 822-827. (doi: 10.1136/jnnp-2022-328903) (PMID:35606105)

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Abstract

Background: Delirium is an important risk factor for subsequent dementia. However, the field lacks large studies with long-term follow-up of delirium in subjects initially free of dementia to clearly establish clinical trajectories. Methods: We undertook a retrospective cohort study of all patients over the age of 65 diagnosed with an episode of delirium who were initially dementia free at onset of delirium within National Health Service Greater Glasgow & Clyde between 1996 and 2020 using the Safe Haven database. We estimated the cumulative incidence of dementia accounting for the competing risk of death without a dementia diagnosis. We modelled the effects of age at delirium diagnosis, sex and socioeconomic deprivation on the cause-specific hazard of dementia via cox regression. Results: 12 949 patients with an incident episode of delirium were included and followed up for an average of 741 days. The estimated cumulative incidence of dementia was 31% by 5 years. The estimated cumulative incidence of the competing risk of death without dementia was 49.2% by 5 years. The cause-specific hazard of dementia was increased with higher levels of deprivation and also with advancing age from 65, plateauing and decreasing from age 90. There did not appear to be a relationship with sex. Conclusions: Our study reinforces the link between delirium and future dementia in a large cohort of patients. It highlights the importance of early recognition of delirium and prevention where possible.

Item Type:Articles
Additional Information:SPL is funded by a Clinical Academic Fellowship from the Chief Scientist Office, Scotland (CAF/19/04). JC is supported by funding from the Medical Research Council (MR/S035753/1), the Wellcome Trust (104025/Z/14/Z), Versus Arthritis (22453) and the Inger and George M Simpson Donation.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Leighton, Dr Samuel and Cavanagh, Professor Jonathan and Deligianni, Dr Fani and Jackson, Dr Eric and Herron, Dr James
Authors: Leighton, S. P., Herron, J. W., Jackson, E., Sheridan, M., Deligianni, F., and Cavanagh, J.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Science and Engineering > School of Computing Science
Journal Name:Journal of Neurology, Neurosurgery and Psychiatry
Publisher:BMJ Publishing Group
ISSN:0022-3050
ISSN (Online):1468-330X
Published Online:23 May 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Journal of Neurology, Neurosurgery and Psychiatry 93(8): 822-827
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
304212TNF antagonism and brain monocyte recruitment in sickness behaviour in rheumatoid arthritisJonathan CavanaghMedical Research Council (MRC)MR/S035753/1III - Immunology
171331Consortium of Neuroimmunology of Mood Disorders and Alzheimer's DiseaseJonathan CavanaghWellcome Trust (WELLCOTR)104025/Z/14/ZHW - Mental Health and Wellbeing
306717Probing the Rheumatoid Arthritis Brain to Expose Central Pain PathwaysNeil BasuVersus Arthritis (ARTRESUK)22453III - Immunology