The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Oct 2013
Does preoperative risk for delirium moderate the effects of postoperative pain and opiate use on postoperative delirium?
To investigate whether preoperative risk for delirium moderates the effect of postoperative pain and opioids on the development of postoperative delirium. ⋯ High levels of postoperative pain and using high opioid doses increased risk for postoperative delirium for all patients. The highest incidence of delirium was among patients who had high preoperative risk for delirium and also had high postoperative pain and used high opioid doses.
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Am J Geriatr Psychiatry · Oct 2013
Comparative StudyA prediction rule for the development of delirium among patients in medical wards: Chi-Square Automatic Interaction Detector (CHAID) decision tree analysis model.
To predict development of delirium among patients in medical wards by a Chi-Square Automatic Interaction Detector (CHAID) decision tree model. ⋯ We propose a validated CHAID decision tree prediction model to predict the development of delirium among medical patients.
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Am J Geriatr Psychiatry · Oct 2013
White-matter hyperintensities predict delirium after cardiac surgery.
Postoperative delirium is a common psychiatric disorder among patients who undergo cardiac surgery. Although several studies have investigated risk factors for delirium after cardiac surgery, the association between delirium and cerebral white-matter hyperintensities (WMH) on magnetic resonance (MR) imaging has not been previously studied. The aim of this study was to identify general risk factors for delirium, as well as to examine the specific relationship between WMH and delirium. ⋯ The results of this study suggest that white-matter abnormality is one of the most important risk factors for development of delirium after cardiac surgery. These factors can be used for prediction and prevention of delirium following cardiac surgery.
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Am J Geriatr Psychiatry · Oct 2013
Delirium in the acute phase after stroke and the role of the apolipoprotein E gene.
To study the association between the epsilon 4 allele of apolipoprotein E (APOEε4) and delirium in a stroke population. ⋯ There was no association between the presence of an APOEε4 allele and the occurrence of delirium in the acute phase after stroke.
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Am J Geriatr Psychiatry · Oct 2013
Apolipoprotein E ε4 and later-life decline in cognitive function and grip strength.
Presence of the apolipoprotein E (APOE) ε4 allele is a risk factor for dementia, whereas the ε2 allele offers protection against dementia. There is also evidence for a relationship between APOE genotype and changes in cognitive function. It is not clear, however, whether this relationship stems from undetected disease in persons genetically more vulnerable to dementia. This study examined whether APOE genotype was associated with either initial performance or change in performance on a range of cognitive and noncognitive tasks, after accounting for possible preclinical dementia. ⋯ Over a 12-year period, findings indicate that APOE ε4-related cognitive decline in older community-dwelling populations is due to a higher likelihood of preclinical dementia among ε4 carriers. When possible dementia cases are removed from the analyses, ε4 associations with cognitive decline become statistically unreliable.