The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Jan 2001
Survival of hospitalized elderly patients with delirium: a prospective study.
The authors tested the relationship between clinically diagnosed delirium during hospitalization and increased mortality after accounting for pre-hospital measures of global cognition, physical functioning, and medical comorbidity. Patients (N=102), 53 of which were hospitalized during the course of a year, received the Mini-Mental State Exam, Physical Self-Maintenance Scale, Cumulative Illness Rating Scale, and 15-item Geriatric Depression Scale. Mortality rates were determined at discharge and after 3 years. ⋯ Three-year mortality in the hospitalized subjects was 75% for delirium patients vs. 51% for control patients (risk ratio=2.24). Delirium occurring during hospitalization places elderly subjects at long-term risk of mortality. This effect is not accounted for by earlier measures of cognitive, functional, or health status.
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Am J Geriatr Psychiatry · Jan 2001
Severity and course of delirium in medically hospitalized nursing facility residents.
Delirium is a common and serious complication of medical illness in frail elderly patients. The authors report on a series of nursing facility delirium patients followed for 3 months during and after acute medical hospitalization. Delirium was persistent to time of death or hospital discharge in 72%. ⋯ A purely hypoactive delirium vs. a hyperactive or mixed was associated with delirium persistence. Delirium is associated with high mortality and frequent persistence. Additional research is needed to clarify who is at risk for delirium with associated persistence and/or mortality.
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Am J Geriatr Psychiatry · Jan 2000
Comparative StudyMental status change in older surgical patients. Cognition, depression, and other comorbidity.
The authors studied patients age 60 and over to assess the effect of elective surgery as a precipitating factor for cognitive decline over the postoperative year. They found an association between change in test performance and age, physical disability, and number of depressive symptoms. However, persistent decline in Mini-Mental State Exam scores was associated with identifiable factors related to the initial surgery in only 3/ 251 (1 percent of cases). Depression and new onset of acute illness were confounding factors in the assessment of cognitive decline.