Abstract / Description of output
ABSTRACTBackground:Delirium is heterogeneous and can vary by etiology.
OBJECTIVES: We sought to determine how delirium subtyped by etiology affected six-month function and cognition.
DESIGN: Prospective cohort study.
SETTING: Tertiary care, academic medical center.
PARTICIPANTS: A total of 228 hospitalized patients > 65 years old were admitted from the emergency department (ED).
MEASUREMENTS: The modified Brief Confusion Assessment Method was used to determine delirium in the ED. Delirium etiology was determined by three trained physician reviewers using a Delirium Etiology checklist. Pre-illness and six-month function and cognition were determined using the Older American Resources and Services Activities of Daily Living (OARS ADL) questionnaire and the short-form Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Multiple linear regression was performed to determine if delirium etiology subtypes were associated with six-month function and cognition adjusted for baseline OARS ADL and IQCODE. Two-factor interactions were incorporated to determine pre-illness function or cognition-modified relationships between delirium subtypes and six-month function and cognition.
RESULTS: In patients with poorer pre-illness function only, delirium secondary to metabolic disturbance (β coefficient = -2.9 points, 95%CI: -0.3 to -5.6) and organ dysfunction (β coefficient = -4.3 points, 95%CI: -7.2 to -1.4) was significantly associated with poorer six-month function. In patients with intact cognition only, delirium secondary to central nervous system insults was significantly associated with poorer cognition (β coefficient = 0.69, 95%CI: 0.19 to 1.20).
CONCLUSIONS: Delirium is heterogeneous and different etiologies may have different prognostic implications. Furthermore, the effect of these delirium etiologies on outcome may be dependent on the patient's pre-illness functional status and cognition.
Original language | English |
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Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | International Psychogeriatrics |
Early online date | 19 Jul 2018 |
DOIs | |
Publication status | E-pub ahead of print - 19 Jul 2018 |